Bile duct cysts in adults. Pitfalls in diagnosis and management.

Six women have been referred to us for treatment of bile duct cysts during the past 6 years. In three patients the disorder was misdiagnosed by the referring institution, and they were admitted because of continuing severe symptoms; two of them had been treated with internal drainage procedures which led to unnecessary treatment delay and complications. Two patients had developed cyst carcinoma, the most feared complication of cyst disease. It is concluded that clinical symptoms are nonspecific, and the diagnosis is only ascertained after complete cholangiographic imaging of the biliary tree. Primary cyst excision and hepaticojejunostomy is the treatment of choice.