Choledochal cyst is an uncommon congenital malformation, generally associated with an abnormal pancreatobilliary duct without the sphincter function. The etiology and pathogenesis are different depending if cysts are intra or extrahepatic. Because of its importance in pathogenesis, nowadays it is recommended to classify them depending if they have a pancreatico-biliary malunion (PBMU).
The clinic presentation is very variable, only 20% of the pacients presents the classic triad: jaundice, abdominal pain and palpable mass, while the most pacients presents some of these symptoms or some of their complications. There are important differences in the clinical presentation depending on the age of presentation and the anatomical type of the malformations.
The gold standard to confirm the clinical suspicion is the abdominal ultrasound. Routinary prenatal ultrasound has produced a significant increment in the early diagnosis.
Once certified the diagnosis, it is necessary to make a pre-operatory study of the cyst. These days it is recommended the colangiopancreatography-MR instead of CPRE.
The aim of the choledochal cyst treatment is to correct the instant symptoms and prevent future complications, such as recurrent pancreatitis, stone formation and carcinoma. The gold standard is the cyst dissection with hepatico-jejunostomy anastomosis. Although the laparotomy incision has been the most used technique, the laparoscopy appears as an alternative.
Key words: Choledochal cyst, pancreatico-biliary malunion, cyst dissection.
Abbreviations: Pancreatico-biliary malunion (PBMU), endoscopic retrograde cholangio-pancreaticography (ERCP).
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