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Updated: May 7, 2026
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Excision of a choledochal cyst and simultaneous hepatic lateral segmentectomy
Y Tsuchida1, F Taniguchi, S Nakahara
1Department of Pediatric Surgery, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113, Tokyo, Japan.
Insights
This study reports a novel surgical approach for a rare pediatric choledochal cyst (CC) involving bilateral intrahepatic ducts. The combined procedure, including hepatic lateral segmentectomy, aimed to prevent complications in a young patient.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Hepatobiliary Surgery
Background:
- Choledochal cysts (CCs) are congenital biliary tract malformations.
- Bilateral intrahepatic involvement presents complex surgical challenges.
- Severe strictures can lead to complications like stone formation.
Purpose of the Study:
- To describe a novel combined surgical technique for a pediatric choledochal cyst with bilateral intrahepatic involvement.
- To address a severe stricture between the left intrahepatic bile duct and common hepatic duct.
- To prevent potential stone formation in the dilated left intrahepatic bile duct.
Main Methods:
- Surgical excision of the choledochal cyst.
- Prophylactic hepatic lateral segmentectomy.
- Management of a severe stricture in the dilated biliary tree.
Main Results:
- Successful treatment of a 4-year-old girl with a complex choledochal cyst.
- The combined procedure effectively managed the stricture and dilated ducts.
- No immediate complications were reported post-surgery.
Conclusions:
- Combined choledochal cyst excision and hepatic lateral segmentectomy is a viable option for complex pediatric cases.
- This approach may prevent long-term complications associated with intrahepatic ductal dilation.
- This represents the first reported instance of this specific combined surgical procedure.
Abstract:
We treated a 4-year-old girl with a choledochal cyst (CC) with bilateral intrahepatic involvement. A severe stricture between the enormously dilated left intrahepatic bile duct and the dilated common hepatic duct was found; this necessitated prophylactic hepatic lateral segmentectomy together with excision of the CC to avoid possible stone formation in the cystically dilated left intrahepatic duct. The choice of the combined procedures was based upon long-term results of other patients in our experience. This is the first such procedure to be reported.
