Choledochal cyst Todani IA case report

BACKGROUND: Choledochal cyst is a congenital dilatation of the biliary tree. It may affect only the extrahepatic bile duct (type I, II and III), intrahepatic (type V) or both (type IVa). Vater first described choledochal cyst in 1723. Open excision was the standard procedure made a great impact in the treatment but since 1995 Farello et al. first reported laparoscopic choledochal cyst excision and this has been used worldwide. CASE REPORT: Female, 17 years old, past medical history two years ago a laparoscopic cholecystectomy for gallbladders. Chief complain epigastric pain one that begins one week ago intensity 10/10, accompanying nausea and jaundiced skin. An ERCP is performed and shows choledochal cyst and a dilator is placed with improved jaundiced tint, cholangiopancretography requested, which reports that the cyst does not invade continuous areas. Then it was performed resection of the cyst by laparoscopy. DISCUSSION: Choledochal cyst is a well described albeit rare clinical entity. Diagnosis and management are important because patients may develop cholangiocarcinoma. The elective treatment for type IA choledochal cyst is resection of the cyst with Roux-en-Y hepaticojejunostomy or hepaticoduodenostomy. CONCLUSION: Laparoscopic surgery is a safe way with a shorter length of stay, less postoperative morbidity and a lower blood loss when compared with open approach. This technique is also favorable from a cosmetic viewpoint. With the improvement of laparoscopic techniques and deftness of surgeons practice, laparoscopic surgery may become the first choice procedure for choledochal cyst.