title: Cystic enlargement of extrahepatic bile ducts.
abstract: BACKGROUND
  Cystic enlargement of the extrahepatic bile duct system is a rare abnormal finding. A congenital origin is usually supposed; however, the pathogenesis is unknown. We report on our experience with extrahepatic bile duct cysts with special regard to cause, treatment, and recurrent disease.
  
  
  METHODS
  From 1976 to 1991, 13 patients, 35 to 74 years of age, were treated for extrahepatic bile duct cysts. Seven patients had previously undergone cholecystectomy. Two patients were admitted because of recurrent disease; neither had undergone curative resection.
  
  
  RESULTS
  In 11 patients a biliojejunal anastomosis with a Roux-en-Y was created after cyst resection; one patient underwent a diverticular stalk resection with end-to-end anastomosis of the choledochal duct. After a mean follow-up of 68 months eight of 10 patients were alive, two of whom complained about cholangitis. Recurrent diffuse dilatation of the remaining choledochus developed in one patient; one other patient died of cholangiocellular carcinoma 2 years after operation.
  
  
  CONCLUSIONS
  In patients who had undergone previous cholecystectomy or with recurrent disease an acquired malformation cannot be excluded. Surgical treatment is always indicated because of imminent complications and should aim at complete resection of cystic tissue. Periodic postoperative evaluation is necessary to detect recurrent disease and malignant transformation.
authors.affiliation: Division of Abdominal and Transplantation Surgery, Hannover Medical School, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Schmid
authors.forename: H J
authors.initials: HJ
authors.lastname: Meyer
authors.forename: B
authors.initials: B
authors.lastname: Ringe
authors.forename: G F
authors.initials: GF
authors.lastname: Scheumann
authors.forename: R
authors.initials: R
authors.lastname: Pichlmayr
mesh_terms: D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002277:Carcinoma / Q000209:etiology; D002758:Cholangiography; D003560:Cysts / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence