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Updated: Apr 20, 2026
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Choledochal cyst in childhood: review of 30 cases
Danielle Nunes Forny1, Saulo Marcos Rebello Ferrante2, Vinícius Gomes da Silveira2
1Federal University of Rio de Janeiro.
Insights
Cystic dilatation of the common bile duct predominantly affects females and is often diagnosed within the first decade. Surgical treatment, including cyst resection, is safe for pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Cystic dilatation of the common bile duct (CBD) is a rare congenital anomaly.
- Accurate diagnosis and timely surgical intervention are crucial for favorable outcomes.
Purpose of the Study:
- To analyze clinical data, diagnosis, and treatment of pediatric patients with CBD cysts.
- To evaluate the efficacy and safety of surgical management in a Brazilian cohort.
Main Methods:
- Retrospective analysis of 30 pediatric patients over 23 years.
- Statistical evaluation of epidemiological, clinical, diagnostic, and treatment data.
- Review of surgical outcomes and complications.
Main Results:
- Female predominance (73.4%) and diagnosis in the first decade (90%).
- Jaundice was the most common symptom; the classic triad was rarely observed.
- Ultrasound sensitivity was 56.6%; 80% underwent cyst resection with Roux-en-Y hepaticojejunostomy.
Conclusions:
- The classic triad is less common than previously reported.
- Surgical treatment involving resection and bilioenteric anastomosis is safe for children.
Objective:
To analyze and discuss the clinical data, diagnosis and treatment of a number of patients with cystic dilatation of the common bile duct of a Brazilian pediatric hospital.
Methods:
We analyzed 30 patients treated at the Martagão Gesteira Institute of Pediatrics and Child Care of the Federal University of Rio de Janeiro for 23 years ,with statistical analysis of epidemiological data, clinical manifestations, diagnosis, treatment and postoperative outcome.
Results:
We observed a marked female predominance (73.4% of cases), the diagnosis being made in the first decade of life in 90% of patients. The most prevalent clinical manifestation was jaundice (70% of cases) and the classic triad of choledochal cyst was not observed. Abdominal ultrasound was the first imaging examination performed, with a sensitivity of 56.6%, with diagnostic definition in 17 children. Two patients (6.6%) had prenatal diagnosis. All patients underwent surgical treatment, cyst resection with Roux-en-Y hepaticojejunostomy being performed in 80% of cases. The incidence of postoperative complications was 13.3% and the mortality rate was 6.6%, ie two patients were diagnosed with Caroli's disease.
Conclusion:
The non-observance of the classic triad of choledochal cyst suggests that its incidence is lower than that reported in the medical literature. The surgical treatment of choledochal cysts, with resection and bilioenteric anastomosis, is safe even for small children.
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