Bile Duct Cysts: Contemporary Surgical Management

Michael L. Kendrick; David M. Nagorney

Disclosures

Curr Opin Gastroenterol. 2009;25(3):240-244. 

In This Article

Abstract and Introduction

Abstract

Purpose of Review: Surgical treatment of bile duct cysts remains the mainstay to reduce cyst-related complications and risk of malignancy. Optimizing treatment outcomes is dependent upon a thorough preoperative evaluation and selecting the appropriate intervention. This review summarizes the recent progress in the evaluation and treatment of bile duct cysts, particularly in relation to contemporary operative approaches.
Recent Findings: Ongoing efforts continue in optimizing the evaluation, classification and management of bile duct cysts. The risk of cholangiocarcinoma is not limited to the bile duct cyst itself and appropriate management and surveillance is paramount. Recent advances in laparoscopic and endoscopic equipment have paralleled an increasing interest in minimally invasive approaches in the management of patients with bile duct cysts. Favorable results of laparoscopic approaches are increasingly reported and suggest the feasibility of this technique in select patients.
Summary: Although the surgical premise of resection has not changed for the treatment of bile duct cysts, there has been an increasing utilization of minimally invasive approaches. Results thus far are promising, but long-term, controlled data is needed before this approach can be considered standard.

Introduction

Bile duct cysts are an uncommon condition, accounting for only 1% of all benign biliary disease.[1] They occur more commonly in children and women. Previous reports have suggested that 80% of bile duct cysts are identified in childhood.[2••] With few exceptions, the mainstay of treatment is complete excision to prevent cyst-related complications or malignancy. Technical advances in laparoscopic equipment and surgeon skills have led to an increasing interest in minimally invasive approaches in the management of bile duct cysts.

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