Introduction: Choledocal disease is uncommon biliary pathology. Most choledochal cysts will present in childhood, about one quarter of patients may only present for the first time during adulthood, with a clinical course slightly differs than that in children and some of these will show malignant transformation. Material and Methods: the clinical data of 12 patients with choledocal cysts were carefully studied from the period of January 2000 to December 2010. Results: There were 3 males and 9 females, with age range from 19 years to 45 years. 10 of the choledochal cysts belong to Todani type IA; 1 type IB and 1 type IVB. Abdominal pain was the commonest presentation. Obstructive jaundice and a malignant change within a choledocal cyst were identified in 1 case. Cholangitis and jaundice in another patient. Anomalous pancreato-biliary junction was recognized in 2 patients. 2 patients were referred after recognition of the choledochal cyst incidentally during laparoscopic cholecystectomy. 10 patients undergoes total excision of the cyst with cholecystectomy and Roux-en-Y hepatico-jejunostomy. One patient presented with liver cirrhosis and advanced hepatic insufficiency, where cystojejunostomy done only. 8 patients remained for follow up and stayed symptom free after a mean of 36 months. Conclusion: Choledochal cyst should be recognized in all patients below 45 years of age presenting with biliary pain, associated with cystic dilatation of bile duct. Cholangiocarcinoma is a dreaded complication of choledochal cyst with adverse outcome because of late diagnosis and a low possibility of resectability. Complete excision of the cyst with restoration of wide biliary_entericcommunication by Roux-en-Y hepaticojejunostomy form the basis of ideal treatment

Choledochal cyst, not just a childhood problem

Introduction: Choledocal disease is uncommon biliary pathology. Most choledochal cysts will present in childhood, about one quarter of patients may only present for the first time during adulthood, with a clinical course slightly differs than that in children and some of these will show malignant transformation. Material and Methods: the clinical data of 12 patients with choledocal cysts were carefully studied from the period of January 2000 to December 2010. Results: There were 3 males and 9 females, with age range from 19 years to 45 years. 10 of the choledochal cysts belong to Todani type IA; 1 type IB and 1 type IVB. Abdominal pain was the commonest presentation. Obstructive jaundice and a malignant change within a choledocal cyst were identified in 1 case. Cholangitis and jaundice in another patient. Anomalous pancreato-biliary junction was recognized in 2 patients. 2 patients were referred after recognition of the choledochal cyst incidentally during laparoscopic cholecystectomy. 10 patients undergoes total excision of the cyst with cholecystectomy and Roux-en-Y hepatico-jejunostomy. One patient presented with liver cirrhosis and advanced hepatic insufficiency, where cystojejunostomy done only. 8 patients remained for follow up and stayed symptom free after a mean of 36 months. Conclusion: Choledochal cyst should be recognized in all patients below 45 years of age presenting with biliary pain, associated with cystic dilatation of bile duct. Cholangiocarcinoma is a dreaded complication of choledochal cyst with adverse outcome because of late diagnosis and a low possibility of resectability. Complete excision of the cyst with restoration of wide biliary_entericcommunication by Roux-en-Y hepaticojejunostomy form the basis of ideal treatment