[Choledochal cysts. Clinico-radiological considerations and surgical technical notes]

A successfully operated case of neonatal common bile duct cyst is described. Cystoduodenostomy was employed. Whether or not this condition is attributable to obstruction dysembryogenesis or aganglia is discussed. Assessment of the anatomopathological features leads to the establishment of three clinical types: cyst properly so called, hernia and diverticulum. True choledochus cyst has three main symptoms: mass, icterus and pain. The other two forms constitute only 5% of the reported cases. They have no distinct signs and the few cases described have been encountered during surgery or necropsy. Diagnosis is complicated by cholostatic cirrhosis and portal hypertension. Treatment is necessarily surgical: excission of the cyst, reconstruction of the main duct by direct anastomosis of the hepatic duct to the duodenum or a jejunal loop prepared according to Roux; anastomosis by means of cystoduodenostomy.