Laparoscopic management of type I choledochal cyst in adults: cyst resection, assisted Roux-en-Y reconstruction and hepaticojejunostomy.

Due to improvement of instrumentation and surgeons' skills, the correction of congenital biliary tract anomalies has been performed by the laparoscopic approach. Because of the high rate of associated malignancy of the biliary system in middle-aged adults, treatment for choledochal cyst is necessary, especially in adult patients. We report on the laparoscopic excision and hepaticoduodenostomy of type I choledochal cysts in five adult patients. To facilitate the procedure, the creation of a Roux-en-Y reconstruction was performed with a minimal abdominal incision. All patients had an uneventful recovery with no major complications. Most were discharged on day 8 after the procedure. At a follow-up of two years, they were still asymptomatic, showing no cholangitis or anicteric. Laparoscopic management for choledochal cyst is an advantageous approach, so it is feasible and will probably become an accepted method in further clinical application.