Surgery of coexisting biliary malformations in choledochal cyst

Five of 13 infants and children with a choledochal cyst had coexisting biliary malformations. The specific lesions were main hepatic duct cyst (2), common hepatic duct stenosis (1), left hepatic duct stenosis (1), and Caroli's disease (1). The malformations were corrected or partially corrected at the time of operative resection of the cyst. The lateral portion of either or both of the major hepatic ducts was incised to the liver hilus thereby dividing areas of stenosis or laying open cystic malformations. Biliary reconstruction was by Roux-en-Y jejunostomy to the fileted common hepatic bile duct. The opportunity to correct coexisting biliary malformations is another advantage of total excision of choledochal cysts.