Treatment of giant choledochal cysts with combined surgery and percutaneous transhepatic cholangial drainage: A case report.

Background: Choledochal cyst is a rare biliary tract disorder with five subtypes categorized based on the anatomical location of cystic dilatation. Type IV (which affects the intrahepatic and extrahepatic ducts) is the most common subtype in adults. Its clinical manifestations are diverse and the disease can potentially become malignant. Currently, the mainstay treatment is surgical excision which is used as a definitive treatment to prevent complications and avoid carcinogenesis. However, the surgical operation for giant choledochal cysts is technically challenging.

Case summary: Here, we present a case of a giant choledochal cyst in an 18-year-old female. The diagnosis of patient was confirmed through magnetic resonance cholangiopancreatography. The patient developed acute cholangitis, and was treated with percutaneous transhepatic cholangial drainage to alleviate symptoms. The final treatment approach was cyst excision followed by Roux-en-Y hepaticojejunostomy, which successfully achieved excellent postoperative recovery.

Conclusion: Ultrasonography and magnetic resonance cholangiopancreatography can effectively diagnose choledochal cysts. Combined percutaneous transhepatic cholangial drainage surgery for giant choledochal cysts is safe and effective.