Delay in Resection of Choledochal Cysts Highlights the Significance of Malignancy Potential: A Case Report

Risks of choledochal cysts include obstructive jaundice, cholangitis, and malignancy. Therefore, are typically resected especially if symptomatic. A 69 year old female who presented with cholangitis due to a common bile duct stone. Past medical history significant for type III cyst recurrent cholangitis. Previous surgical interventions included biliary bypass at age 10 revision in early 20s; was not either surgery. Imaging suggested hepaticojejunostomy stricture leading Initially patient very hesitant undergo any further intervention opted close surveillance. Shortly after develop rigors while still reluctant large procedure did consent resection revision. During the operation, identified, mobilized approximately 80% it excised. Hepaticojejunostomy appeared incorporate remnant gallbladder based on intraoperative evaluation. Cholangiogram attempted through Luschka but completed difficult angle subsequently ligated. New created using original roux limb good drainage right left hepatic lobes demonstrated completion cholangiogram. Final pathology poorly differentiated adenocarcinoma, gallbladder; additionally margin showed invasive adenocarcinoma. Patient then underwent pancreaticoduodenectomy partial hepatectomy complete oncologic resection. In adults presenting symptomatic cyst, excision should be recommended treatment. Risk malignancy is present tree despite Thus, entire inspected multiple areas neoplasm.