Benign Choledochal Cyst Management in Adults: General Surgeons' Perspective in a Non-Tertiary Centre.

BACKGROUND

Choledochal cysts (ChDCs) in adults are rare and mostly benign. Their management involves having either extensive surgery in tertiary centres or conservative long-term surveillance in general hospitals. However, there is a gap in the literature regarding the ideal management approach to adopt in practice. This study explored our experience in this context.

METHODS AND ANALYSIS

This three-year retrospective study was conducted in a district general hospital in the West. The database of magnetic resonance scans of the pancreaticobiliary territory in adults over the study period was reviewed. Patients diagnosed with choledochal cysts through these scans were included in the final analysis. Descriptive statistics were used to analyse the collected quantitative data.

RESULTS

Two thousand thirteen relevant scans were reviewed. Twenty-nine (1.44%) scans showed various types of ChDCs, where the patients' mean age was around 48 years, the female to male ratio was (2.6:1), 70% were Caucasian and around 51% had Type I ChDC. Abdominal pain was the main associated symptom in around half of them. None of the patients had objective evidence of malignancy that would warrant ChDC excision, while one-third had gallstones that necessitated cholecystectomy. All patients had conservative management and were still under surveillance at the end of this study. Neither mortality nor serious morbidity was reported.

CONCLUSIONS

Our findings are consistent with other studies, although we found higher incidence of ChDCs in Caucasians perhaps due to geographical reasons. With the current gap in the literature, we encourage other units to publish their similar experiences. This can help in standardisation of the management protocols of this rare pathology in adults.