title: Bile duct cyst in adults: interventional treatment, resection, or transplantation?
abstract: Cystic dilatations of the bile ducts may be found along the extrahepatic biliary tree, within the liver, or in both of these locations simultaneously. Presentation in adults is often associated with complications. The therapeutic possibilities have changed considerably over the last few decades. If possible, complete resection of the cyst(s) can cure the symptoms and avoid the risk of malignancy. According to the type of bile duct cyst, surgical procedures include the Roux-en-Y hepaticojejunostomy and variable types of hepatic resection. However, the diffuse forms of Todani type V cysts (Caroli disease and Caroli syndrome) in particular remain a therapeutic problem, and liver transplantation has become an important option. The mainstay of interventional treatment for Todani type III bile duct cysts is via endoscopic retrograde cholangiopancreatography. The diagnostic term "bile duct cyst" comprises quite different pathological and clinical entities. Interventional therapy, hepatic resection, and liver transplantation all have their place in the treatment of this heterogeneous disease group. They should not be seen as competitive treatment modalities, but as complementary options. Each patient should receive individualized treatment after all of the clinical findings have been considered by an interdisciplinary team.
authors: Herwig
authors: H
authors: Cerwenka
mesh_terms: D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015529:Choledochal Cyst / Q000175:diagnosis / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D016031:Liver Transplantation; D018579:Patient Selection; D016896:Treatment Outcome
keywords: Bile duct cyst; Caroli disease; Caroli syndrome; Hepatic resection; Interventional treatment; Liver transplantation
references: Gastrointest Endosc. 1994 Nov-Dec;40(6):761-4
references: 7859979
references: Z Kinderchir. 1981 Feb;32(2):144-51
references: 7282042
references: Transpl Int. 2006 May;19(5):381-8
references: 16623873
references: Hepatobiliary Pancreat Dis Int. 2002 Aug;1(3):442-5
references: 14607724
references: Chin Med J (Engl). 2007 Aug 20;120(16):1404-7
references: 17825168
references: Rev Med Chir Mal Foie. 1964 Feb;39:1-70
references: 14134792
references: Endoscopy. 1998 Aug;30(6):559-63
references: 9746166
references: J Am Coll Surg. 2006 Jun;202(6):928-32
references: 16735207
references: Pediatr Surg Int. 2002 May;18(4):247-51
references: 12021972
references: Mayo Clin Proc. 1998 Jan;73(1):80-9
references: 9443684
references: Br J Surg. 1985 Aug;72(8):651-2
references: 4027543
references: Surgery. 2005 Nov;138(5):888-98
references: 16291390
references: Singapore Med J. 2011 May;52(5):e91-3
references: 21633759
references: Arch Surg. 2004 Aug;139(8):855-60; discussion 860-2
references: 15302695
references: J Hepatobiliary Pancreat Surg. 1999;6(3):207-12
references: 10526053
references: Acta Chir Belg. 2012 Sep-Oct;112(5):340-5
references: 23175921
references: Endoscopy. 2001 Jul;33(7):614-9
references: 11473335
references: J Pediatr Surg. 1985 Aug;20(4):449-51
references: 4045674
references: Gastrointest Endosc. 1995 Dec;42(6):589-92
references: 8674935
references: World J Gastroenterol. 2009 May 28;15(20):2550-1
references: 19469009
references: Pediatr Surg Int. 2000;16(5-6):431-2
references: 10955583
references: J Pediatr Surg. 2003 Dec;38(12):1833-6
references: 14666480
references: Br J Surg. 1985 Aug;72(8):641-3
references: 4027540
references: World J Radiol. 2012 Sep 28;4(9):413-7
references: 23024843
references: Pediatr Surg Int. 2005 Jan;21(1):61-3
references: 15316725
references: Liver Transpl. 2008 Jan;14(1):2-3
references: 18161795
references: Pediatr Radiol. 1999 Nov;29(11):807-10
references: 10552056
references: Hippokratia. 2011 Apr;15(2):174-7
references: 22110303
references: Liver Transpl. 2008 Jan;14(1):11-7
references: 18161799
references: Pediatr Surg Int. 1998 Mar;13(2-3):177-9
references: 9563040
references: Am J Surg. 1977 Aug;134(2):263-9
references: 889044
references: Sem Hop. 1958 Feb 18;34(8/2):496-502/SP
references: 13543376
references: Pediatr Surg Int. 2005 Nov;21(11):911-3
references: 16160871
references: J Am Coll Surg. 2008 Dec;207(6):839-46
references: 19183529
references: Hepatobiliary Pancreat Dis Int. 2008 Feb;7(1):97-100
references: 18234647
references: J Laparoendosc Adv Surg Tech A. 2010 Dec;20(10):877-81
references: 20879872
references: Ann Surg. 2010 Oct;252(4):683-90
references: 20881775
references: AJR Am J Roentgenol. 1999 Sep;173(3):619-20
references: 10470889
references: Eur J Pediatr Surg. 1996 Dec;6(6):334-7
references: 9007465
references: Saudi J Gastroenterol. 2012 Jul-Aug;18(4):230-6
references: 22824764
references: J Hepatobiliary Pancreat Surg. 2003;10(5):340-4
references: 14598133
references: Eur J Gastroenterol Hepatol. 2011 Jul;23(7):578-85
references: 21543986
references: Ann Hepatol. 2008 Jan-Mar;7(1):80-2
references: 18376372
references: Surg Today. 2002;32(11):1019-22
references: 12444445
references: Ann Surg. 2008 Feb;247(2):357-64
references: 18216545
references: Am J Pathol. 2005 Jan;166(1):49-60
references: 15631999
references: BMC Gastroenterol. 2012 Mar 30;12:29
references: 22458359
references: Sem Hop. 1958 Feb 18;34(8/2):488-95/SP
references: 13543375
references: Liver Transpl. 2001 Jan;7(1):59
references: 11150424