Giant choledochal cyst type 4A: a surgical challenge

Choledochal cysts are rare congenital anomalies of the biliary tract. There are 5 subtypes of choledochal cyst and in adults type 4 is the most common. Choledochal cyst rarely exceeds the size of 6cm in the reported literature. Only a handful of cases of giant choledochal cysts are reported in the literature. Here we report a case of a 33-year-old lady who presented with a huge abdominal mass and on evaluation was found to have a giant choledochal cyst type 4A. The patient underwent excision of the extrahepatic hugely dilated choledochal cyst with cholecystectomy and reconstruction was done by Roux-en-Y hepaticojejunostomy to the confluence of the right and left hepatic duct at the hilum.