Congenital biliary cysts in Indian adults

Only one report of congenital biliary cysts has been described so far from India, and that was in children. We present our experience with 22 adult Indian patients with this condition. The main presenting symptoms were abdominal pain, icterus, and fever, and the classical triad of jaundice, pain, and abdominal mass was seen in only one patient. The mean age of presentation was 25.5 +/- 10.1 yr, and females predominated (82%). Type Ia cysts (fusiform choledochal cyst) were the commonest. Intrahepatic cysts were seen in four patients; three of these were associated with extrahepatic biliary ductal cysts (type IVa). Internal drainage procedures performed elsewhere in six patients were followed by recurrent cholangitis, necessitating excision of the cyst. Hence, the preferred operation for congenital biliary cysts is cyst excision and hepaticojejunostomy.