[Diagnosis and treatment of congenital choledochal cysts in adults].

We report the experience with 97 adult patients with bile duct cysts in the past 30 years (1965-1995). The median age at time of initial therapy in our department was 37 years (range, 16 to 78 years). Clinical symptoms in most cases were non-specific, resulting in delayed diagnosis. 74 patients (76%) had coexistent pancreaticohepatobiliary disease. Carcinoma of the biliary duct occurred in 16 patients (17%). Abnormal pancreatobiliary duct junction (APBDJ) was found in 28 patients. 94 patients underwent a total of 169 biliarytract procedures. Cyst excision with Roux-en-y hepaticojejunostomy and internal drainage were the main procedures. The result of long-term follow-up shows that internal drainage frequently resulted in recurrent cholangitis and cyst malignancy which need reoperation. In contrast, cyst excision was associated with a significantly lower incidence of recurred cholangitis and lower occurrence of malignancy. Thus, cyst excision with Roux-en-y hepaticojejunostomy is recommended as the treatment of choice for adult patient.