title: Choledochal cysts in adults and the importance of differential diagnosis.
abstract: OBJECTIVE
  Choledochal cysts, congenital cystic dilatations of the hepatobiliary tree, present diagnostic dilemmas. In countries where hydatid disease is endemic, this rare pathology may be overlooked. The importance of this issue led us to reexamine our clinical material to evaluate our findings and management.
  
  
  METHODS
  This study examined 12 patients (11 females, 1 male) who were treated at the University of Istanbul, Cerrahpasa Medical Faculty, with the diagnosis of choledochal cyst between 1981 and 2000. The cases were examined retrospectively, and the complaints, diagnostic methods, findings, and management were discussed.
  
  
  RESULTS
  Ten of the cysts were type I (83.3%), one was type II (8.3%), and one was type IV (8.3%). Three of the patients underwent operation with the diagnosis of liver hydatid cyst, but during the operation the cysts were found to be choledochal cysts. In six of the patients, the cysts were correctly diagnosed, and they were excised.
  
  
  CONCLUSIONS
  Contemporary approaches to treating choledochal cysts focus on total removal of the cyst. In a country where hydatic diseases are endemic, hepatobiliary cystic lesions are often misdiagnosed clinically and radiologically as hydatid cysts. Considering that percutaneous and laparoscopic approaches are being increasingly adopted for treatment of hydatid cysts, the problematic area must be subjected to thorough examination for cystic lesions. The possibility of choledochal cysts must always be kept in mind; otherwise, an unfavorable process may begin for both patient and surgeon.
authors.affiliation: Department of General Surgery, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey.
authors.forename: Ali Vedat
authors.initials: AV
authors.lastname: Durgun
authors.forename: Emre
authors.initials: E
authors.lastname: Gorgun
authors.forename: Metin
authors.initials: M
authors.lastname: Kapan
authors.forename: M Faik
authors.initials: MF
authors.lastname: Ozcelik
authors.forename: Ramazan
authors.initials: R
authors.lastname: Eryilmaz
mesh_terms: D000293:Adolescent; D000328:Adult; D015529:Choledochal Cyst / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004444:Echinococcosis, Hepatic / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography