Choledochal cyst--a review of 25 cases.

Twenty-five cases of choledochal cysts operated at the University Hospital between 1969 and 1981 were reviewed. Nineteen of the patients were females. An accurate pre-operative diagnosis of choledochal cyst was made in 10 patients (40%). We have found the 99Tcm-diethyl-IDA (EHIDA) scan to be the safest and most sensitive diagnostic tool. In recent years excision has been performed whenever possible in view of reports of malignancy developing in the cyst wall. It has a lower morbidity and re-operation rate compared to internal drainage. In excision we advise the use of a cuff of the cyst wall for a wider anastomosis. As the biliary tract shrinks and retracts into the porta following excision of the cyst, stricture formation may still occur despite a wide anastomosis.