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Bile duct cysts in adults
The British Journal of Surgery
|November 19, 2004
Summary
Bile duct cysts, though rare, are increasingly diagnosed in adults. Surgical management is standard, aiming to prevent complications and malignancy, with good outcomes reported.
Area of Science:
- Hepatobiliary Surgery
- Gastroenterology
- Surgical Oncology
Background:
- Bile duct cysts are uncommon congenital anomalies with debated origins.
- Historically prevalent in young Asian females, they are now increasingly identified in Western adults.
Purpose of the Study:
- To review the pathophysiology, clinical presentation, and management controversies of bile duct cysts in adults.
- To emphasize recent literature on adult bile duct cyst management.
Main Methods:
- A comprehensive Medline literature search was conducted.
- Articles focusing on pathophysiological concepts, clinical behavior, and management controversies were prioritized.
- Emphasis was placed on studies published within the last two decades.
Main Results:
- Bile duct cysts are increasingly reported in adult populations.
- Type IV cysts are more prevalent in adults than in children.
- Non-specific abdominal discomfort is a common presentation, often preceded or complicated by hepatobiliary/pancreatic disease.
Conclusions:
- Surgical intervention for bile duct cysts aims to mitigate complications and reduce malignant transformation risk.
- Standard treatment involves complete cyst resection, cholecystectomy, and Roux-en-Y hepaticojejunostomy.
- Ongoing debate surrounds hepatic resection for specific cyst types and the utility of minimally invasive approaches, though outcomes are generally favorable with low mortality.