Treatment Of Choledochal Cyst Research Articles

A trans-umbilical single-site plus one robotic-assisted surgery for choledochal cyst resection in children.

The purpose of this study is to compare the intraoperative and postoperative outcomes of a trans-umbilical single-site plus one robot-assisted surgery and a trans-umbilical single-site laparoscopic surgery in the treatment of choledochal cysts. We retrospectively analyzed clinical data from 49 children diagnosed with choledochal cysts who were admitted to our hospital between June 2020 and December 2023. Among these patients, 24 underwent a trans-umbilical single-site plus one Da Vinci robot-assisted surgery (the robot group) and 25 underwent a trans-umbilical single-site laparoscopic-assisted surgery (the laparoscopic group). We compared differences in intraoperative and postoperative outcomes between the two groups. There was no significant difference between the two groups of patients in terms of gender, age, weight, clinical symptoms, maximum cyst diameter, type, postoperative complications, and facial expression, leg movement, activity, crying, and comfortability (FLACC) scoring (p > 0.05). Compared with the patients in the laparoscopic group, those in the robot group had less intraoperative bleeding [10 (8-12) vs. 15 (11.5-18) ml, p < 0.001] and required less postoperative drainage tube indwelling time [5 (4-6) vs. 7 (5.5-8) day, p < 0.001], less postoperative fasting time [4 (3-4) vs. 6 (5-7) days, p < 0.001], and less postoperative hospitalization time [6 (6-7) vs. 8 (6-10) days, p < 0.001], but they required more operative time [385.5 (317.0-413.3) vs. 346.0 (287.0-376.5) min, p = 0.050] and consumed more hospitalization expenses (79,323 ± 3,124 vs. 31,121 ± 2,918 yuan, p < 0.001). The results of this study showed a shorter hospitalization time, quicker postoperative recovery, and less tissue damage but a higher cost and a longer operation time in patients who chose robotic surgery rather than laparoscopic surgery. With the continuous expansion of the scale of installed robot-assisted surgical systems and the gradual accumulation of the technical experience of surgeons, robot-assisted surgery may slowly surpass, and shows a trend to replace, laparoscopy because of its advantages.

Treatment and Outcome of Choledochal Cyst, our Experience in Sheikh Russel National Gastroliver Institute and Hospital, Mohakhali Dhaka, Bangladesh

Objectives: The aim of the study was to evaluate the demographic information, clinical features, surgical methods, postoperative complications, and outcomes at 6 months for patients with choledochal cysts who were treated at the Sheikh Russel National Gastroliver Institute and Hospital. The goal was to assess the outcomes of radical cystectomy versus partial hepatectomy in the treatment of choledochal cysts. Methods: This was a retrospective analysis of 36 patients who had choledochal cysts and were treated with either a total cystectomy (n=30) or partial hepatectomy (n=6). Results: The groups that underwent radical cystectomy and partial hepatectomy had similar age ranges, sex distributions, and types of cysts. The majority of the cysts were type I (83.3% of the total cystectomy group) and type V (100% of the partial hepatectomy group). Other associations included: gallstones (26.7% vs. 83.3%) and Abnormal pancreatic biliary duct junction (APBDJ) (36.7% vs. 16.7%). An increased frequency of post-operative pain, jaundice, upper abdominal swelling, and fever was noted in the group that had a radical cystectomy. Minimal post-operative complications were seen in both groups. At 6 months, the rates of complications were similar, with hypertrophic scars being the most common (30.7% for radical cystectomy and 25% for partial hepatectomy). Conclusion: The groups that had radical cystectomy and partial hepatectomy were of similar demographics, cyst types, abnormalities, clinical traits, and complication rates post surgery and at 6 months. Both procedures are still good ways to treat choledochal cysts, and this small group doesn't clearly show which is better. To get a better idea of differences in long-term results, bigger studies are needed.

Preliminary exploration of animal models of congenital choledochal cysts.

Various animal models have been used to explore the pathogenesis of choledochal cysts (CCs), but with little convincing results. Current surgical techniques can achieve satisfactory outcomes for treatment of CCs. Consequently, recent studies have focused more on clinical issues rather than basic research. Therefore, we need appropriate animal models to further basic research. To establish an appropriate animal model that may contribute to the investigation of the pathogenesis of CCs. Eighty-four specific pathogen-free female Sprague-Dawley rats were randomly allocated to a surgical group, sham surgical group, or control group. A rat model of CC was established by partial ligation of the bile duct. The reliability of the model was confirmed by measurements of serum biochemical indices, morphology of common bile ducts of the rats as well as molecular biology experiments in rat and human tissues. Dilation classified as mild (diameter, ≥ 1 mm to < 3 mm), moderate (≥ 3 mm to < 10 mm), and severe (≥ 10 mm) was observed in 17, 17, and 2 rats in the surgical group, respectively, while no dilation was observed in the control and sham surgical groups. Serum levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, and total bile acids were significantly elevated in the surgical group as compared to the control group 7 d after surgery, while direct bilirubin, total bilirubin, and gamma-glutamyltransferase were further increased 14 d after surgery. Most of the biochemical indices gradually decreased to normal ranges 28 d after surgery. The protein expression trend of signal transducer and activator of transcription 3 in rat model was consistent with the human CC tissues. The model of partial ligation of the bile duct of juvenile rats could morphologically simulate the cystic or fusiform CC, which may contribute to investigating the pathogenesis of CC.

Laparoscopic excision versus open excision for the treatment of choledochal cysts: a systematic review and meta-analysis

To determine if laparoscopic excision is more effective than open excision in the treatment of choledochal cysts. A systematic review of randomized clinical trials in 3 databases measuring the efficacy of laparoscopic and open excision of choledochal cysts was performed. The authors considered international and national reports, whose results were analyzed in detail. Mean duration of laparoscopic excision was 51 min, open excision - 35.4 min. Length of hospital-stay after laparoscopic excision ranged between 5 and 74 days, after open excision - between 7 and 146 days. Bile leakage rate was 1-2% and 4%, respectively. Laparoscopic excision was followed by lower complication rate. Morbidity and mortality in laparoscopic excision was 20% and 0%, in open excision - 60% and 3.3%, respectively. Laparoscopic excision is more effective than open excision in the treatment of choledochal cysts.

Non-stapled, total laparoscopic Roux-en-Y anastomosis: A safe and effective procedure for radical pediatric choledochal cyst excision

BackgroundLaparoscopic or robot-assisted surgery has become the main pediatric minimal invasive surgery for a choledochal cyst (CDC). However, the Roux-en-Y jejunal limb was created extracorporeally in most reports and intracorporeally in a few reports using an endoscopic stapler. Objectives/methodsTo investigate the safety and feasibility of non-stapled laparoscopic Roux-en-Y reconstruction in the radical treatment of congenital choledochal cysts (CDC). Between January 2019 and February 2023, 40 patients diagnosed with CDC underwent non-stapled laparoscopic Roux-en-Y reconstruction (non-stapled totally laparoscopic radical treatment, NTLR), 40 patients underwent conventional reconstruction (conventional laparoscopic radical treatment, CLR) included as control. Their clinical data such as intraoperative blood loss, proportion of transit laparotomy, length of operation, postoperative fasting times, postoperative drainage time, postoperative hospital stay, hospitalization cost, and postoperative complications were retrospectively analyzed. Conclusionnon-stapled laparoscopic Roux-en-Y reconstruction is feasible and safe in total laparoscopic radical treatment of CDC. It may have the following advantages: rapid recovery of postoperative gastrointestinal function, short hospitalization, no age limit on the patient and no additional hospitalization costs, which is worthy of promotion and application.

Laparoscopic and robotic approaches for treatment of choledochal cysts in adults

Background: While well-described for hepatic and pancreatic resection, the minimally invasive (MIS) approach in the treatment of choledochal cysts (CC) has been under-reported. Due to the technical complexity and steeper learning curve of minimally invasive biliary reconstruction, the MIS approach has not been as widely adopted in biliary surgery. We herein review the use of laparoscopic and robotic-assisted surgery in the treatment of CC. Methods: A comprehensive review of the literature was performed on the use of laparoscopic and robotic-assisted surgery in the treatment of CC. Results: Similar morbidity and mortality rates were noted among patients undergoing laparoscopic choledochal cyst resection (LCCR) compared with previous data from patients in the literature who had undergone an open approach (OCCR, open choledochal cyst resection); however, LCCR was associated with longer operative times and high conversion rates, largely attributable to the learning curve given the technically challenging nature of the procedure. The robotic platform (RCCR, robotic choledochal cyst resection) has been shown to offer an advantage in the hepaticojejunostomy anastomosis portion of CC resection vs. laparoscopy while providing comparable short-term outcomes compared with the LCCR approach. Conclusion: A minimally invasive approach to CC likely has improved perioperative outcomes with shorter LOS, return to baseline function, as well as improved cosmesis vs. OCCR. Longer operative times with minimally invasive approaches to CC have been attributed to steep learning curves, which have improved over time as surgeons become more facile with this technique. Both LCCR and RCCR have demonstrated similar rates of long-term postoperative complications and overall survival when compared to OCCR.

Type IVA Choledochal Cyst in Adult: A Case Report

Choledochal cyst is a congenital disease of the biliary tract with extrahepatic and/or intrahepatic biliary tree dilatation. There is a female majority (4:1). Controlling biliary sepsis and curing pancreatitis are prerequisites of surgery. Here, a 35-year-old female patient, came with complaints of epigastric and right upper abdominal pain for three days. On examination per abdomen was soft, non distended, right hypochondriac tenderness was present, no guarding, bowel sounds were audible. Magnetic Resonance Cholangiopancreatography (MRCP) was done which showed fusiform dilatation of Common Bile Duct (CBD), Common Hepatic Duct (CHD), right and left hepatic duct, along with mild dilatation of central intrahepatic biliary radicals (4.8-5 mm)- suggestive of choledochal cyst type IVA. Hepatico-duodenostomy was done. The entire extrahepatic biliary tree should be removed when the choledochal cyst is diagnosed whether or not symptoms are present. Despite being congenital, the condition is typically discovered in adulthood as well. The treatment of choledochal cysts has evolved. The current standard of care is cyst excision and hepaticojejunostomy

Modified single-port versus multiport laparoscopic choledochal cysts excision and Roux-en-Y hepaticojejunostomy: a retrospective comparative cohort study.

The feasibility, benefit, and safety of multiport laparoscopic choledochal cyst (CDC) excision and Roux-en-Y hepaticoenterostomy (MPCH) have been consistently confirmed. Single-port laparoscopic CDC excision and Roux-en-Y hepaticoenterostomy (SPCH) has advantages of less traumatic and more cosmetic beneficial, it has been reported in some case series, but it is technically challenging. We propose a modified technique to reduce technical difficulty in performing SPCH. The safety and feasibility of modified SPCH were compared with those of conventional multiport laparoscopic CDC excision. A total of 43 consecutive patients who diagnosed with CDC by preoperative magnetic resonance cholangiopancreatography (MRCP) and underwent SPCH (n=24) and MPCH (n=19) for choledochal cyst (CDC) by a single surgeon between January 1, 2018, and January 1, 2021, were enrolled. The baseline clinical characteristics, efficacy and safety outcomes of short-term were compared. The baseline clinical characteristics of the MPCH and SPCH groups are comparable. Average postoperative length of hospital stay was shorter in the SPCH group than in the MPCH group, but the difference was not statistically significant (7.00 vs. 7.58 days; P>0.99). The operation time (281.75 vs. 277.3 min; P=0.58) and the amount of blood loss (9.33 vs. 16.68 mL; P=0.57) were similar in both groups. A significantly greater number of drainage tubes were placed in the MPCH group compared to the SPCH group (11 vs. 5; P=0.01). One patient suffered from hepaticoenterostomy anastomosis stricture in the SPCH group. The short-term outcome of modified SPCH is comparable with MPCH according to our study. It is easily adaptable treatment of CDC.

Postoperative surveillance of bile duct cysts through modified “Roux en Y” hepaticojejunostomy by transgastric endoscopic access

Presenter: André de Moricz MD | Irmandade Santa Casa de Misericórdia de São Paulo Background: Choledochal cyst (CC) is a congenital dilatation of extra or intrahepatic bile ducts and is usually associated with pancreaticobiliary malformation, risk of choledocholithiasis, and biliary tract cancer. The standard treatment for CC consists of complete cystic resection with biliodigestive anastomosis; the hepaticojejunostomy is the preferred type of reconstruction due to lower complication rates. Methods: A survey of all choledochal cyst cases operated by the Pancreas group of our service was carried out from July 1984 to March 2020, and 22 patients who underwent surgical treatment were identified. Based on the need for subsequent access to biliodigestive anastomosis for intrahepatic lithiasis treatment, biliary stricture, and further cancer surveillance on remnant intrahepatic cysts, a modified “Roux-en-Y” was proposed hepaticojejunostomy providing surveillance of remnant choledochal cyst and treatment for postoperative hepaticojejunostomy complications by less invasive strategy. Results: Considering the possibility of late complications such as stenosis or incomplete resection of the cyst, a surveillance strategy must be considered. All the current procedures depend on advanced radiology, generate discomfort to the patient in ostomy cases, or rely on more invasive and repeated biliary surgical procedures. The new technique proposes a jejunal segment of approximately 10,0 to 15,0 cm kept far from the anastomosis allowing its placement, without tension, in the anterior gastric wall below the small curvature between the body the stomach antrum, which enables access to the bile ducts through Endoscopic Retrograde Cholangiopancreatography (ERCP) guided by Endoscopic Ultrasound (EUS) and therefore less invasive access than the ones described in the literature. Conclusion: The modified “Roux en Y” hepaticojejunostomy is a new and straightforward technique that allows surveillance of patients submitted to the biliodigestive anastomosis of any kind and are useful in patients submitted to choledochal cyst resection once it enables vigilance of the remnant bile duct and makes interventions possible when needed.

Laparoscopic treatment of choledochal cysts in adults: case report with video and review of literature

Laparoscopic treatment of choledochal cysts in adults: case report with video and review of literature

Total cyst excision with Roux-en-Y hepaticojejunostomy for choledochal cyst management: a single-center experience

Background Choledochal cystis considered as a cystic dilatation of the biliary tract, which is a rare disease. It is more common in children, but its incidence and diagnosis are increasing in adults, representing 20% of the cases. Aim To evaluate morbidity and mortality rates following hepaticojejunostomy done for patients, either child or adult, with choledochal cyst. Patients and methods A total of 30 patients were evaluated, comprising 13 children and 17 adults. The study was done in the period from January 2013 till January 2020, in the Advanced Hepato-Pancreatico-Biliary Center, Zagazig University Hospital, Egypt. Results Abdominal pain was the commonest complaint in all patients. Jaundice was present in 80%. Total cyst resection with reconstruction of the biliary tract with a standard 60–60 cm Roux-en-Y hepaticojejunostomy was done in 28 (93.33%) patients. Left hepatectomy was done in two patients with Caroli’s disease. There was no recurrence in our follow-up period. Conclusion Total cyst excision with Roux-en-Y hepaticojejunostomy is the standard treatment of choledochal cyst. It was associated with low incidence of recurrence and also decreased long-term postoperative complications and malignancy.

Large choledochal cyst initially interpreted as Mirizzi syndrome - case report and literature review

Introduction. Choledochal cysts are congenital anomalies manifested as focal or diffuse cystic dilatation of the bile ducts. They are mostly diagnosed in childhood. The magnetic resonance and surgical management are the gold standard diagnostic and treatment modality. Case outline. We present a male patient who was presumed to have Mirizzi syndrome. This presumption was discarded by additional imaging procedures and by later surgical treatment. It was confirmed that it was a large choledochal cyst filled with stones. Considering the diagnosis and good patient?s general condition, we opted for surgical treatment. Conclusion. There are several surgical techniques that can be used in the treatment of choledochal cysts, wherein each is intended as a complete resection of the cyst with histological confirmation. Operative techniques do not affect the outcome of the treatment, but the time and extent of surgical resection, as well as any metaplasia of the epithelium, do.

Experience in the Treatment of Choledochal Cyst with Robot-Assisted Surgery in Children: and "The Current State of Minimally Invasive Surgery in this Anomaly”

Experience in the Treatment of Choledochal Cyst with Robot-Assisted Surgery in Children: and "The Current State of Minimally Invasive Surgery in this Anomaly”

Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy in children: a single-institution prospective cohort study

Background: Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is gaining popularity as a treatment for choledochal cyst in children. The aim of this study is to determine the feasible and safe of the laparoscopic excision with Roux-en-Y hepaticojejunostomy, and evaluate the short-term outcomes after treatment for children with choledochal cyst.Methods: A prospectively of 51 consecutive pediatric patients undergoing laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy performed by one surgeon cysts at Hue Central Hospital from June 2012 to December 2017 was studied.Results: The mean operative time was 214.7±67.95 minutes (range, 100~360 minutes), including the time for intraoperative cholangiography. There were two children requiring blood transfusion. Time to first flatus was 40.35±28.55 hours in average. The mean time to drain removal was 2.89±1.02 days. Mean postoperative hospital stay was 9.31±3.43 days. 6 out of 51 cases having early complications, including 2 cases of pancreatitis and 4 cases of bile leakage. Most of cases (90.5%) were classified as good after 10 days to 3 months of follow-up.Conclusions: Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy was feasible and safe in children. The short-term outcomes were good in most cases.

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Hepaticojejunostomy in Children: A Single-Institution Prospective Cohort Study

AIM: Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is gaining popularity as a treatment for choledochal cyst in children. The aim of this study is to determine the feasible and safe of the laparoscopic excision with Roux-en-Y hepaticojejunostomy, and evaluate the short-term outcomes after treatment for children with choledochal cyst. Methods: A prospectively of 51 consecutive pediatric patients undergoing laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy performed by one surgeon cysts at Hue Central Hospital from June 2012 to December 2017 was studied. Results: The mean operative time was 214.7 ± 67.95 minutes (range, 100~360 minutes), including the time for intraoperative cholangiography. There were two children requiring blood transfusion. Time to first flatus was 40.35 ± 28.55 hours in average. The mean time to drain removal was 2.89 ± 1.02 days. Mean postoperative hospital stay was 9.31 ± 3.43 days. 6/51 cases having early complications, including 2 cases of pancreatitis and 4 cases of bile leakage. Most of cases (90.5%) were classified as good after 10 days to 3 months of follow-up. Conclusion: Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy was feasible and safe in children. The short-term outcomes were good in most cases.

Laparoscopic hepaticoduodenostomy as a method of treatment of choledochal cysts in children

Laparoscopic hepaticoduodenostomy as a method of treatment of choledochal cysts in children

OUTCOME OF THE LAPAROSCOPIC CHOLEDOCHAL CYST EXCISION

Objectives: To study the clinical and subclinical characteristics, and the treatment results of the laparoscopic choledochal cyst excision. Subjects and Methods: patients with bile duct cyst were diagnosed and treated by laparoscopic excision at the Hue Central Hospital from 6/2013 to 9/2017. Result: The common bile duct cyst was type I with highest ratio (90.77%), in which type Ic occupied the rate was 53.84%. The most common clinical manifestation was abdominal pain which occupied 87.69% of cases. The average time of opreation was 197.58 ± 46.57. Drain pipe was removed within 1-4 days after surgery. The average time of postoperative treatment was 8.7 ± 3.8 days. The rate of early complications after surgery was 3.07%. The rate of postoperative complications was 1.54%. Conclusion: Laparoscopic treatment of choledochal cyst is safe, feasible and efficient in medical high-tech center Key words: laparoscopic, bile duct cyst

Duel-stage treatment for biliary cysts with cholangitis during pregnancy.

Background & Objective:Biliary cysts in pregnant women are a complex medical issue, especially when complicated with cholangitis. It is a serious and life-threatening diagnosis that can seriously endanger both the expectant mother and the fetus. However, during pregnancy, surgical treatment would lead to further complications and higher fetal mortality. Here, we propose a novel therapeutic approach that would be safe for both mother and child during pregnancy, with a definitive treatment postponed until after delivery.Methods:In this retrospective study we have summarized the clinical course of six adult patients diagnosed with choledochal cysts during pregnancy. Treatment was conducted in two stages, firstly, percutaneous cholecystostomy under ultrasound guidance and sustained negative pressure suction until delivery, and secondly, selective choledochal cyst excision when the patients recovered from delivery.Results:All the six patients gave birth to healthy babies. Four patients had Type-I choledochal cysts, and underwent Roux-en-Y hepaticojejunostomy surgery. Two patients had a Type-IV choledochal cyst. The first patient with Type-IV choledochal cyst underwent anastomosis between the secondary hepatic bile duct and jejunum and the second patient underwent laparoscopic cyst internal drainage. No serious complications were recorded after gallbladder drainage or during the perioperative period.Conclusions:Based on our single-centre experience we can conclude that treatment of choledochal cyst with cholangitis during pregnancy can be conducted safely and efficiently through the two stages strategy that we proposed in this paper. The first stage should be percutaneous cholecystostomy followed by elective surgical treatment following delivery.

Evaluation of the learning curve of laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy in children: CUSUM analysis of a single surgeon\u2019s experience

IntroductionLaparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is gaining popularity as a treatment for choledochal cyst (CDC) in children. However, the learning curve for this challenging laparoscopic procedure has not been addressed. The aim of this study is to determine the characteristics of the learning curve of this procedure. This may guide the training in institutions currently not using this technique.MethodsA prospectively collected database comprising all medical records of the first 104 consecutive patients undergoing laparoscopic CDC excision and Roux-en-Y hepaticojejunostomy performed by one surgeon was studied. Multifactorial linear/logistic regression analysis was performed to identify patient-, surgeon-, and procedure-related factors associated with operating times, rates of adverse event, and length of postoperative stay.ResultsCumulative sum analysis demonstrated a learning curve for laparoscopic choledochal cyst excision of 37 cases. Comparing the early with the late experiences (37 vs. 67 cases), the surgeon-specific outcomes significantly improved in terms of operating times (352 vs. 240 min; P < 0.001), postoperative complication rate (13.5 vs. 1.5 %; P = 0.02), and the length of hospital stay (9.4 vs. 7.8 days; P = 0.01). After multivariate analyses, independent predictors of operating times included the completion of the learning curve (CLC) (OR 0.68, 95 % CI 0.63–0.73) and adhesion score (ORmiddle 1.25, 95 % CI 1.08–1.45; ORhigh 1.40, 95 % CI 1.20–1.62; compared with the low score); significant predictors of perioperative adverse outcomes were CLC (OR 0.07, 95 % CI 0.02–0.34) and comorbidities prior to the surgery (OR 30.65, 95 % CI 1.71–549.63). The independent predictors of length of postoperative stay included CLC, preoperative comorbidities, and perioperative adverse events.ConclusionsCLC for laparoscopic choledochal cyst excision is 37 cases. After CLC, not only the operative time is reduced, the complications, adverse results, and the length of hospital stay all decreased significantly. The learning curve can be used as the basis for performance guiding the training.

Anatomic anomalies of pancreatic duct in children with chronic pancreatitis

Choledochal cyst (CC) is closely associated with anomalous arrangement of the pancreaticobiliary duct, which is considered a high-risk factor for biliary tract malignancy. Early diagnosis and early treatment for CC could lead to a good prognosis. This study investigated late complications and long-term outcomes after surgery for CC.Fifty-six patients with CC and over 10 years of postoperative follow-up were analyzed retrospectively. All patients had undergone total resection of the extrahepatic bile duct and hepaticojejunostomy.Six patients showed liver dysfunction manifested in the first 10 years after surgery, but all returned to normal thereafter. Dilatation of intrahepatic bile ducts persisted in 6 postoperatively, and in 3, this was still apparent more than 10 years after. Recurrent abdominal pain was encountered in 3, 1 had pancreas divisum with a pancreatic stone, and 1 had adhesive small bowel obstruction. Two patients developed biliary tract malignancy. A 14-year-old girl died of recurrent common bile duct cancer 2 years after the initial resection of CC with adenocarcinoma. A 26-year-old man with repeated cholangitis owing to multiple intrahepatic bile stones developed cholangiocarcinoma 26 years after the initial resection of CC. Event-free survival rate and overall survival rate were 89% (50/56) and 96% (54/56), respectively.Choledochal cyst generally has an excellent prognosis with early total resection and reconstruction. Long-term surveillance for the development of malignancy is still essential, especially if there is ongoing dilatation of the intrahepatic bile duct or biliary stones.