Choledochal Cyst Surgery Dhaka

• Type I (most common, ~80%) — fusiform dilatation of the extrahepatic bile duct
• Type II — supraduodenal diverticulum
• Type III (choledochocele) — intra-duodenal cyst
• Type IV — multiple intra- and extrahepatic cysts
• Type V (Caroli disease) — intrahepatic only; may require liver resection or transplant

Untreated choledochal cysts cause recurrent abdominal pain, jaundice, pancreatitis, cholangitis, and (most importantly) carry a 15–30% lifetime risk of cholangiocarcinoma. The risk increases with age. Even asymptomatic cysts in adults should be excised because internal drainage procedures (cyst-jejunostomy alone) do not eliminate cancer risk and are now considered obsolete.

The standard operation is complete cyst excision with Roux-en-Y hepaticojejunostomy. The cyst is dissected away from the portal vein and hepatic artery, and the entire dilated segment is removed up to healthy bile duct above and to the pancreatic duct junction below. A 50–60 cm Roux loop of jejunum is brought up and anastomosed to the healthy bile duct. The operation takes 4–6 hours. Laparoscopic and robotic approaches are available for selected paediatric and slim adult patients.

Hospital stay is typically 7–10 days. Patients resume normal diet within a week and return to work in 4–6 weeks. Long-term follow-up with liver function tests and ultrasound every 1–2 years is essential because a small residual cancer risk persists in any retained intrahepatic ducts. Book a consultation to plan timing of surgery.