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November 1961

Choledochal Cysts with Emphasis on Preoperative Diagnosis

Author Affiliations

Present address: Madigan General Hospital, Tacoma, Wash. (Dr. Jesseman).; Assistant Chief, Department of Surgery (Dr. Jesseman), and Resident in General Surgery (Dr. Treasure), Fitzsimmons General Hospital, Denver 30.

Arch Surg. 1961;83(5):689-693. doi:10.1001/archsurg.1961.01300170045009

The choledochal cyst represents a common bile duct dilatation of unknown etiology but probably of congenital origin. An excellent review of 403 authentic and 16 doubtful cases by Alonso-Lej, Rever, and Pessagno,1 done in 1959, indicated that it is a more common entity than originally believed.

There appears to be a unanimity of opinion that this is a serious condition and one which, if not corrected, will lead to repeated bouts of cholangitis, eventual hepatitis, cirrhosis, and death or rupture and death. Therefore, it is felt that the following case reports with emphasis on preoperative diagnosis will be of value.

Pathology  The classification of choledochal cyst is somewhat controversial. However, Alonso-Lej1 set up a useful classification in which the cysts are divided into 3 types. Type 1, the most common, represents congenital cystic dilatation of the common duct. Type 2 represents a congenital diverticulum of the common duct