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Updated: Aug 20, 2026

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
04:14

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

Published on: February 28, 2025

Choledochal cyst in adults: aetiological considerations to intrahepatic involvement

Shih-Ping Cheng1, Tsen-Long Yang, Kuo-Shyang Jeng

  • 1Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan. chengsp@med-assn.org.tw

ANZ Journal of Surgery
|November 20, 2004
PubMed

Insights

Anomalous pancreaticobiliary duct junction (APBDJ) is strongly linked to adult choledochal cysts, especially type IVa. Careful monitoring of these cysts, with or without intrahepatic involvement, is recommended due to potential complications.

Area of Science:

  • Gastroenterology
  • Hepatobiliary Surgery
  • Medical Imaging

Background:

  • Choledochal cysts are rare biliary tree anomalies, infrequently presenting in adults.
  • Anomalous pancreaticobiliary duct junction (APBDJ) is frequently associated with choledochal cysts, but its prevalence across different cyst types requires clarification.

Purpose of the Study:

  • To investigate the prevalence of APBDJ in adult choledochal cysts based on cyst anatomy.
  • To assess the relationship between APBDJ and clinical presentation and outcomes in adult choledochal cysts.

Main Methods:

  • A cohort of 39 adult patients with choledochal cysts (Todani types I, IVa, IVb) was analyzed.
  • Prevalence of APBDJ was compared between different choledochal cyst types.
  • Patients were followed for a mean of 7.2 years post-cyst excision.

Main Results:

  • No significant differences in age, sex, or manifestations were observed between cyst types.
  • Type IVa choledochal cysts showed a significantly higher frequency of associated APBDJ (100%) compared to type I cysts (P < 0.05).
  • Recurrent cholangitis episodes occurred in 3 type I and 4 type IVa cyst patients, all with preoperatively diagnosed APBDJ.

Conclusions:

  • APBDJ is closely associated with adult choledochal cysts, particularly type IVa.
  • Intrahepatic involvement may result from progressive enzymatic destruction, suggesting a link between APBDJ and cyst progression.
  • Adult choledochal cysts associated with APBDJ require vigilant monitoring for potential complications.
Abstract

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