Wang Dong-Dong, Du Yong-Yue, Li Yong-Zhao, Wang Wei, Ma Tian-Long, Xu Xue-Chao, Mi Chen, Wang Si-Yang, Cui Feng, She Yuan-Hua, Wang Man-Cai, Yang Han-Teng
Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China.
World J Gastrointest Surg. 2025 Jun 27;17(6):107351. doi: 10.4240/wjgs.v17.i6.107351.
Choledochal cyst is a rare biliary tract disorder with five subtypes categorized based on the anatomical location of cystic dilatation. Type IV (which affects the intrahepatic and extrahepatic ducts) is the most common subtype in adults. Its clinical manifestations are diverse and the disease can potentially become malignant. Currently, the mainstay treatment is surgical excision which is used as a definitive treatment to prevent complications and avoid carcinogenesis. However, the surgical operation for giant choledochal cysts is technically challenging.
Here, we present a case of a giant choledochal cyst in an 18-year-old female. The diagnosis of patient was confirmed through magnetic resonance cholangiopancreatography. The patient developed acute cholangitis, and was treated with percutaneous transhepatic cholangial drainage to alleviate symptoms. The final treatment approach was cyst excision followed by Roux-en-Y hepaticojejunostomy, which successfully achieved excellent postoperative recovery.
Ultrasonography and magnetic resonance cholangiopancreatography can effectively diagnose choledochal cysts. Combined percutaneous transhepatic cholangial drainage surgery for giant choledochal cysts is safe and effective.
胆总管囊肿是一种罕见的胆道疾病，根据囊肿扩张的解剖位置可分为五种亚型。IV型（累及肝内和肝外胆管）是成人中最常见的亚型。其临床表现多样，该疾病有潜在恶变可能。目前，主要治疗方法是手术切除，作为预防并发症和避免癌变的确定性治疗手段。然而，巨大胆总管囊肿的手术操作在技术上具有挑战性。
在此，我们报告一例18岁女性巨大胆总管囊肿病例。通过磁共振胰胆管造影确诊。患者发生急性胆管炎，经皮经肝胆管引流治疗以缓解症状。最终治疗方法是囊肿切除并 Roux-en-Y 肝空肠吻合术，术后恢复良好。
超声和磁共振胰胆管造影能有效诊断胆总管囊肿。巨大胆总管囊肿经皮经肝胆管引流联合手术安全有效。
