Bile-duct cyst with cystlithiasis: a case report

Cystic dilatation of the biliary tree is an uncommon congenital condition, most often discovered in infancy. It should be suspected in an adult who has a history, over a long period, of intermittent pain in the right upper quadrant, episodes of jaundice or cholangitis, or both, and has a palpable mass in the right hypochondrium. Ultrasonography and especially endoscopic retrograde cholangiopancreatography allow the biliary cyst to be diagnosed preoperatively more often than previously. The authors describe the case of a 60-year-old woman with congenital cystic dilatation of extra- and intrahepatic bile ducts with cystlithiasis that followed an unusual course. Of the various theories of causation, Babbitt 's is now the most widely accepted, especially since the advent of endoscopic retrograde cholangiopancreatography. The presence of stones is an uncommon and late complication. The treatment is surgical, excision of the biliary cysts being the treatment of choice; however, Roux-en-Y choledochocystojejunostomy is performed when excision is technically impossible.