Isolated Right Hepatic Duct Biliary Cyst With a Literature Review: Is It Time to Expand the Todani Classification?

Area of Science:

• Hepatobiliary surgery
• Gastroenterology
• Pediatric surgery

Background:

• Biliary tract cysts are congenital dilatations of the biliary system, classified by Todani.
• Solitary intrahepatic biliary tract cysts represent a rare presentation.
• Advancements in imaging have revealed cases not fitting the existing classification.

Observation:

• The original Todani classification categorizes biliary tract cysts into five types.
• Rare presentations, such as solitary intrahepatic cysts, pose classification challenges.
• New imaging techniques identify diverse biliary duct cyst morphologies.

Findings:

• Existing classification systems may not encompass all biliary tract cyst variants.
• Uncommon biliary duct cyst presentations necessitate a revised classification framework.
• The study identifies specific rare cases that fall outside the current Todani system.

Implications:

• An expanded Todani classification is proposed to better categorize all biliary tract cysts.
• Improved classification will aid in diagnosis and treatment planning for rare biliary duct cysts.
• This work contributes to a more comprehensive understanding of congenital biliary anomalies.