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Malignant tumors in choledochal cysts

R Tsuchiya, N Harada, T Ito

Annals of Surgery

|July 1, 1977

Summary

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Congenital cystic dilatation of the common bile duct (choledochal cyst) can be associated with malignant tumors. Surgical excision of these cysts, including those with cancer, offers successful treatment outcomes.

Area of Science:

Gastroenterology
Surgical Oncology
Hepatobiliary Surgery

Background:

Congenital cystic dilatation of the common bile duct (choledochal cyst) is a rare congenital anomaly.
Association between choledochal cysts and biliary tract malignancies is a known but infrequent complication.

Observation:

This study reviewed 17 patients treated for choledochal cysts between 1960 and 1975.
Three patients had malignant tumors within the cysts, and one had gallbladder carcinoma.
Preoperative diagnosis of adenocarcinoma was achieved via cytologic examination of bile during endoscopic pancreaticocholangiopancreatography (EPCG) and percutaneous transhepatic cholangiography (PTC).

Findings:

Definitive treatment involved surgical excision of cysts with tumors, including choledochojejunostomy, cystoduodenostomy with external drainage, and cholecystectomy with colon resection.

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Successful excision of choledochal cysts was achieved in 11 patients.

Three of the successfully treated patients had associated malignant tumors within the biliary tract.

Implications:

Surgical management, including complete excision, is crucial for choledochal cysts, especially when complicated by malignancy.
Early diagnosis and surgical intervention are vital for improving outcomes in patients with choledochal cysts and associated cancers.
This highlights the importance of considering malignancy in the differential diagnosis of choledochal cysts and emphasizes the role of advanced imaging and cytology.