DOI: 10.11648/j.js.20261405.12 ISSN: 2330-0930

Congenital Cystic Dilatations of the Bile Ducts in Adults

Habarek Meziane, Dali Katia, Bentabet Amar, Merzouki Sonia, Ait Samir, Matmar Kader, Aissat Abdenour, Ladjouzi Fares, Ait Saliha, Saad Saliha, Sbaihi Abdelah
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Introduction: Cystic dilatation of the bile ducts, or choledochal cyst, is a rare congenital disorder of the biliary tree, usually discovered in childhood. It is uncommon and only presents in adulthood in 20% of cases. Material and methods: Over a 23-year period from 2003 to 2026, we operated on 12 consecutive patients with congenital cystic dilatation of the bile ducts. There were 2 men and 10 women with a mean age of 49.1 years (range: 21–78 years). The cystic dilatation of the bile ducts was classified according to the Todani classification as type I in 9 cases, type II in 1 case, type IVa in 1 case, and type V in 1 case. Complete resection of the cyst was performed for types I, II, and IV. In one case, an adenocarcinoma of the common bile duct cyst was discovered upon examination of the surgical specimen. Drug treatment was prescribed for type V. Results: All our patients were symptomatic. The isolated or combined clinical signs leading to the discovery of the lesion were abdominal pain in all patients, jaundice and fever in 75% (9 cases) and 41.7% (5 cases), respectively. Postoperative complications were marked by episodes of acute cholangitis, which were more or less successfully controlled by percutaneous drainage combined with antibiotic therapy. Conclusion: The treatment of congenital cystic dilatations of the bile ducts must follow a strategy adapted to each type of malformation. Cystoenteric anastomosis is contraindicated, and resection should be as complete as possible.

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