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Updated: Jul 10, 2026
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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Choledochal cysts in infancy and childhood
Atul Mishra1, Nitin Pant, Rajiv Chadha
1Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India.
Indian Journal of Pediatrics
|November 6, 2007
Summary
Choledochal cyst (CC) management differs between infants and older children. Primary excision of the cyst with hepaticodochojejunostomy (HDJ) is effective for CC in all age groups, including those with biliary perforation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Hepatobiliary Surgery
Background:
- Choledochal cysts (CC) are congenital biliary malformations requiring surgical intervention.
- Clinical presentation and management strategies for CC vary significantly with patient age.
Purpose of the Study:
- To analyze the clinical presentation, management, and treatment outcomes of 41 choledochal cyst cases.
- To compare infantile and pediatric CC presentations and treatment efficacy.
Main Methods:
- Retrospective review of 41 consecutive choledochal cyst cases managed between 1999 and 2006.
- Patients were categorized into infantile (<1 year) and pediatric (>1 year) groups.
- Diagnostic modalities included ultrasonography, CECT, DISIDA scan, and MRCP. Surgical management involved cyst excision with hepaticodochojejunostomy (HDJ) or hepaticodochoduodenostomy (HDD).
Main Results:
- Infantile CC presented with jaundice and hepatomegaly; older children with pain and jaundice.
- Type Ic and If CC were observed, with differing prevalence between age groups.
- Primary excision with HDJ was the predominant surgical approach. Two postoperative deaths occurred due to sepsis. Short-term follow-up was satisfactory for 39 patients.
Conclusions:
- Infants with CC represent a distinct clinical group requiring tailored evaluation.
- Primary excision of the choledochal cyst with HDJ is a safe and effective treatment for CC across all age groups, including complex cases with biliary perforation.
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