Choledochal cyst: survey by the surgical section of the American Academy of Pediatrics.

Choledochal cyst is a rare surgical condition that requires prompt surgical treatment to prevent biliary cirrhosis and portal hypertension. The results in this series indicate that the preferred surgical management is: (A) cyst excision and anastomosis of the common bile duct to a Roux-en-Y jejunal loop or (B) direct anastomosis of the "cyst" to a Roux-en-Y jejunal loop. A higher long-term complication rate was seen in patients after direct anastomosis of the duodenum to the adjacent "cyst." Choledochal cyst with biliary atresia probably represents an operable form of extrahepatic bile duct atresia. Of 22 patients with biliary atresia, 11 are living and well without liver disease. The importance of early surgical attention cannot be over emphasized.