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Updated: Jul 5, 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

Synchronous Todani types I and III choledochal cysts in a 10-month-old-infant: type IVb

Oliver B Lao1, Sharon Stein, Kim A Ely

  • 1Department of Surgery, University of Washington, 1959 NE Pacific Street, Box 356410, Seattle, WA 98195, USA. olao@u.washington.edu

Pediatric Surgery International
|April 29, 2008
PubMed

Insights

This case report details a rare synchronous occurrence of Type I and Type III choledochal cysts in an infant. Successful surgical management highlights the importance of accurate diagnosis for pediatric biliary anomalies.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Imaging

Background:

  • Choledochal cysts are congenital biliary tract dilations, classified by Todani et al.
  • Synchronous Type I and Type III choledochal cysts represent an extremely rare presentation.
  • Pancreaticobiliary malunion is often associated with choledochal cysts.

Observation:

  • A 10-month-old infant presented with jaundice, light stools, and irritability.
  • Abdominal sonography revealed a Type I choledochal cyst and a separate cystic mass in the pancreatic head.
  • MRCP confirmed Type I choledochal cyst and a coexisting Type III choledochocele with pancreaticobiliary malunion.

Findings:

  • The infant underwent successful resection of the Type I choledochal cyst with Roux-en-Y hepaticojejunostomy.
  • Marsupialization of the Type III choledochocele via anterior duodenotomy was performed.
  • Five-year follow-up showed no symptom recurrence, with the child thriving.

Implications:

  • Accurate identification of mixed choledochal cyst types is crucial for surgical planning.
  • This case expands understanding of rare choledochal cyst associations beyond traditional classifications.
  • Detailed reporting aids epidemiologic tracking and improves outcomes for rare pediatric biliary anomalies.

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