What is a Choledochal Cyst?

A choledochal cyst is a congenital cystic dilation of the bile duct. It can present in childhood or adulthood with jaundice, abdominal pain and recurrent cholangitis. If left untreated, it carries a significant risk of malignant transformation (cholangiocarcinoma) — up to 20–30% lifetime risk.

Surgical Treatment

Complete surgical excision of the cyst is mandatory — both to relieve symptoms and to eliminate the cancer risk. The standard operation is:

• Cyst excision — complete removal of the cystic bile duct segment
• Roux-en-Y Hepaticojejunostomy — reconstruction of bile flow by joining the hepatic duct to a loop of small intestine (Roux limb)

This operation requires expertise in hepatobiliary surgery. Dr. Ashok Kumar's MCh training from SGPGI and extensive biliopancreatic surgical experience makes him well-qualified to perform this procedure safely at Charak Hospital.

Types of Choledochal Cysts (Todani Classification)

• Type I — most common; fusiform dilation of common bile duct
• Type II — diverticulum of CBD
• Type III — choledochocoele (dilation within duodenal wall)
• Type IV — multiple intrahepatic and extrahepatic cysts
• Type V — Caroli disease (intrahepatic duct dilation only)