[Surgery and cystic malformations of the bile ducts]

Bile duct cysts are usually diagnosed during infancy and childhood, although 20-30% become symptomatic in adults, sometimes as late as the seventh decade of life. The Todani modification of the Alonso-Lej classification is now generally accepted and has clarified a previously confusing literature. Treatment is surgical: resectional rather than the traditional drainage procedures are indicated. This aggressive approach decreases but does not abolish the risk of cancer in the hepato-bilio-pancreatic tree. The patients must therefore be followed up for life.