Abstract
Introduction
A choledochal cyst is a congenital or acquired dilation of the biliary tree, affecting the extrahepatic and/or intrahepatic bile ducts. It is more prevalent in females and Asian populations. Early diagnosis and appropriate surgical management are essential to prevent complications and ensure optimal outcomes. This paper aimed to describe the clinical presentation, diagnostic approaches, surgical management, and postoperative outcomes of adult patients with choledochal cysts at a Cambodian tertiary center.
Methods
We conducted a retrospective case series of seven adult patients with choledochal cysts who underwent surgical treatment between January 2020 and December 2023 by checking medical records. We collected data on symptoms, imaging, Todani type classification, surgical procedure, and postoperative outcomes. Data were shown as mean, median, frequency and percentage
Results
Seven patients (five females, two males) were included, with a mean age of 33.7 years. Common symptoms include abdominal pain and jaundice. According to Todani's classification, these included 1 case of type Ia, 3 cases of type Ic, and 3 cases of type IVa. All patients underwent complete cyst excision with Roux-en-Y hepaticojejunostomy and cholecystectomy. No malignancy was found on histology in any case. The median follow-up duration was 24 months.
Conclusion
Choledochal cysts should be considered in the differential diagnosis of adult patients presenting with epigastric or right upper quadrant pain, jaundice, or signs of cholangitis. Thorough preoperative imaging and classification are essential for planning surgical intervention. Complete cyst excision with Roux-en-Y hepaticojejunostomy remains the standard treatment for extrahepatic types. Long-term follow-up is necessary for monitoring potential complications and early detection of malignant transformation.