Endosonographically confirmed type III choledochal cyst managed with endoscopic needle-knife division

Area of Science:

• Gastroenterology
• Surgical Innovation
• Biliary Tract Diseases

Background:

• Type III choledochal cysts, characterized by cystic dilatation of the intraduodenal common bile duct, are rare and carry a low malignancy risk.
• Traditional treatments include surgical resection or endoscopic fenestration with marsupialization.
• This case focuses on a type IIIA choledochal cyst, the rarest subtype.

Purpose of the Study:

• To describe a novel endoscopic approach for managing a symptomatic type IIIA choledochal cyst.
• To evaluate the efficacy and safety of endoscopic needle-knife division and marsupialization for choledochal cyst treatment.

Main Methods:

• A 19-year-old male with a large type IIIA choledochal cyst and obstructive symptoms underwent endoscopic needle-knife division and marsupialization.
• The procedure involved creating an incision to decompress and marsupialize the cyst, facilitating drainage into the duodenum.

Main Results:

• The endoscopic needle-knife division and marsupialization successfully resolved the large choledochal cyst.
• The patient experienced no adverse events during the 12-month follow-up period, with complete resolution of symptoms.

Conclusions:

• Endoscopic needle-knife division and marsupialization represent a potentially effective novel treatment for symptomatic choledochoceles.
• Long-term safety data are necessary to fully establish this approach for choledochal cyst management.