Choledochocele-containing stones.

The case of a 68-yr-old woman with a rare type of Alonso-Lej's type III choledochal cyst (choledochocele) is described. This patient was admitted to the hospital because of right upper quadrant pain. Endoscopy revealed a bulge of the papilla of Vater resembling a submucosal tumor. Endoscopic retrograde cholangiopancreatography demonstrated cystic dilation of the terminal portion of the common bile duct. In addition, small stones were located in the gallbladder, the common bile duct, and the cystic lesion. Cholecystectomy, resection of the cystic lesion, and papilloplasty were performed. Histologically, the interior wall of the cyst was lined with biliary mucosa and demonstrated no evidence of malignancy. We reviewed 63 reported cases of choledochocele in Japan and 65 reported cases in the English literature. The clinical features of choledochoceles were similar in both groups, and they were associated with a minimal risk of malignant degeneration. These findings may have important implications for treatment.