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Updated: Dec 21, 2025
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Choledochal cyst- unusual presentation in the adult phase: Case report
Victor Vinicius Monteiro Lins de Albuquerque1, Frank Pinheiro De Macedo1, Ketlen G Costa2
1Digestive System Surgery Service at Getúlio Vargas Teaching Hospital (HUGV), Avenida Apurinã, 4 - Praça 14 de Janeiro, Manaus, Amazonas, 69020-170, Brazil.
Insights
Bile duct cysts, rare in adults, present with nonspecific symptoms. Advanced imaging like MRCP aids diagnosis, enabling timely surgical intervention to prevent complications.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Diagnostic Imaging
Background:
- Bile duct cysts are congenital dilations of bile ducts, typically diagnosed in childhood.
- Adult presentation is uncommon and frequently linked to serious complications.
Observation:
- A 38-year-old female presented with prolonged abdominal pain, initially without cholestatic signs.
- Imaging revealed cholelithiasis and extrahepatic bile duct dilatation, with MRI confirming a choledochal cyst.
Findings:
- Adult choledochal cysts often manifest with nonspecific symptoms, necessitating advanced diagnostic imaging.
- Magnetic Resonance Cholangiopancreatography (MRCP) is the current gold standard for diagnosing bile duct cysts.
Implications:
- Early diagnosis through improved medical imaging is crucial for timely treatment in adults.
- Surgical resection with Roux-en-Y hepaticojejunal anastomosis offers the best prognosis, preventing complications.
Introduction:
Bile duct cysts are congenital malformations characterized by bile duct dilatation with intra and/or extrahepatic localization. About 80% of cases are diagnosed in childhood, so their presentation in adults is rare and repeatedly associated with complications.
Presentation Of Case:
A 38-year-old female patient complained of severe abdominal pain for one month, with no associated cholestatic signs. She underwent abdominal ultrasonography that showed cholelithiasis with extrahepatic bile duct dilatation and underwent cholangiography (MRI), which revealed fusiform dilatation of the proximal portion of the hepatocholedochal, compatible with choledochal cyst.
Discussion:
In adult patients, clinical manifestations are usually nonspecific, and the diagnosis is established by medical imaging. Magnetic resonance cholangiopancreatography (MRCP) is the gold standard diagnostic today. Treatment with better prognosis consists of total cyst resection with hepaticojejunal anastomosis and intestinal transit reconstruction with Roux-en-Y.
Conclusion:
Bile duct cysts are a rare condition in adults. Currently, increasing access to more accurate medical imaging enables early diagnosis, contributing to the use of therapeutic methods in appropriate time, avoiding development of complications.
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