The surgical management of 27 adults with choledochal cysts in reviewed as 9 years experience ranging from 17 to 87 years of age. Twenty two patients were females and the clinical symptoms were characterized by right upper quadrant abdominal
pain,
jaundice and palpable mass, but this classic triad was presented in only 6 cases(22%). Coexistent hepatobiliary pathologic findings were more complex and frequent than those that occurred in children including cystolithiasis or cholelithiasis,
pancreatitis and malignancy. According to the Todani's classification, the proportion of the cysts was 17 cases of type I, 8 cases of type IV, 2 cases of type V. There were three interesting associated conditions such as pregnancy, huge
pancreatic
duct
stones and pancreas head cancer. Operative procedures were total excision of cyst and hepaticojejunostomy(Roux-en Y or loop) in 23 cases, jejunal interposition in 2 cases, left lateral segmentectomy of the liver in 2 cases. Cyst excision with
hepaticojejunostomy or jejunal interposition is recommanded as a treatment of choice for adults to eliminate pancreatitis by pancreaticobiliary disconnection and risk of many sequales including malignancy.
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