Infants may present with nausea, vomiting, and failure to thrive as a result of luminal compression. Over half of the patients present with a smooth paplable abdominal mass in the right hypochondrium. Complications of choledochal cysts are largely due to obstruction and include jaundice, stone formation, recurrent cholangitis, hepatic absess, portal vein thrombosis, pancreatitis, cyst rupture, secondary biliary cirrhosis and carcinoma. The cyst is often the site of malignant change, but there is also an increased risk of malignancy in any part of the bile ducts, gallbladder and pancreas. Most tumors are adenocarcinomas, although squamous tumors and cholangiocarcinoma occur.
Treatment is usually surgical.
Complete cyst resection and biliary bypass is the accepted treatment, although anatomic considerations often make complete resection difficult. Hepatic resection and even liver transplantation has been advocated for intrahepatic cysts. Disseratatio de scirrhus viscerum occasione sectionis viri tympanite defunte. Case of dilatation of the common bile duct. Todani T, Watanabe Y, Narusue M et al.