Bile duct cyst

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[edit] Discussion of Bile duct cyst

  • According to the Todani system, there are five types of bile duct cysts.

[edit] Type 1: Choledochal Cyst

  • Account for 80% to 90% of all bile duct cysts
  • Characterized by fusiform dilation of the extrahepatic bile duct
  • Theorized that choledochal cysts form as the result of reflux of pancreatic secretions into the bile duct via anomalous pancreaticobiliary junction.
  • Cyst should be resected completely to prevent associated complications (i.e. ascending cholangitis and malignant transformation).

[edit] Type 2: Diverticulum

  • Account for 3% of all bile duct cysts
  • Represent a true diverticulum.
  • Saccular outpouchings arising from the supraduodenal extrahepatic bile duct or the intrahepatic bile ducts.

[edit] Type 3: Choledochocele

  • Account for 5% of all bile duct cysts
  • Represent protrusion of a focally dilated, intramural segment of the distal common bile duct into the duodenum.
  • Choledochoceles may be successfully managed with endoscopic sphincterotomy, surgical excision, or both, in symptomatic patients.

[edit] Type 4: Multiple Communicating Intra- and Extrahepatic Duct Cysts

  • Second most common type of bile duct cysts (10%)
  • Subdivided into subtypes A and B.
    • Type 4A: Fusiform dilation of the entire extrahepatic bile duct with extension of dilation of the intrahepatic bile ducts
    • Type 4B: Multiple cystic dilations involving only the extrahepatic bile duct.

[edit] Type 5: Caroli's Disease

  • Caroli's disease is a rare form of congenital biliary cystic disease manifested by cystic dilations of intrahepatic bile ducts
  • Association with benign renal tubular ectasia and other forms of renal cystic disease.

[edit] Images

Patient #1:

[edit] See Also

[edit] External Links

[edit] References for Bile duct cyst