Laparoscopic treatment of choledochal cysts in adults: case report with video and review of literature

Choledochal cyst is a congenital disease classified in 5 types according to Todani classification and associated to biliary stones, cholangitis, secondary biliary cirrhosis and increased risk of cholangiocarcinoma. The surgical approach ranges from simple cyst excision to complex surgery. Recently, more and more surgeons have started using a minimally invasive approach to treat this disease, mainly for type I and II. We described a totally laparoscopic approach to a Type II choledochal cyst. In addition, a PubMed literature review focusing on laparoscopic surgical resection of choledochal cyst was performed and summarized. We present the case of 25-years-old women with a Type II choledochal cyst diagnosed on Magnetic resonance cholangiopancreatography (MRCP). The patient underwent laparoscopic resection of the cyst and common bile duct followed by Roux-en-Y hepaticojejunostomy without any intraoperative complications. Postoperatively, the patient experienced a bleeding arising from the stapler line of the cul-de-sac of the Roux en Y loop managed conservatively. The patient was discharged at post-operative day-8. Despite the laparoscopic approach is challenging, it has been widely adopted and is now preferred to the open surgery. This approach should be confined to expert centers and performed by skilled hepato-biliary and laparoscopic surgeons.