Answers
What is a choledochal cyst?
Short answer
A choledochal cyst is a balloon-like widening of the bile duct that is present from birth. It is more common in Asian people and in women. It can cause pain, jaundice, pancreatitis or infection, and it carries a risk of bile duct cancer over time, so surgical removal is usually advised.
Symptoms
- Pain in the upper belly, sometimes in attacks
- Jaundice, which may come and go
- Episodes of pancreatitis or bile duct infection (fever with chills)
- Sometimes no symptoms, and it is found on a scan done for another reason
Tests
An ultrasound may first show a widened duct. MRCP shows the shape and type of the cyst and how it joins the pancreatic duct. EUS gives more detail when needed.
Treatment
Most choledochal cysts are removed by surgery, and the liver is reconnected to the intestine so that bile can drain (hepaticojejunostomy). This relieves symptoms and greatly lowers the cancer risk. Some types near the duodenum are managed through an endoscope. After treatment, regular follow-up is advised.
When to see a doctor
See a gastroenterologist if a scan mentions a choledochal cyst, or for repeated upper belly pain with jaundice or pancreatitis. Fever with chills and jaundice needs emergency care.
Food with a choledochal cyst
Eat more
- Small, regular, lower-fat meals if you get attacks of pain
- Plenty of fluids
- After surgery: a normal, balanced diet once recovered
Cut down
- Large, fatty meals that can trigger pain
- Alcohol, which can trigger pancreatitis
- Delaying care for fever with jaundice
Good to know
- Diet does not shrink or treat the cyst; surgery is the treatment.
- After surgery, most people eat normally.
Common questions
Can it be found in adults?
Yes. Although present from birth, many are found in teenagers or adults when they cause pain, jaundice or pancreatitis, or on a scan done for something else.
Can it be treated without surgery?
For most types, no. Surgery removes the cyst and the cancer risk that comes with it. A few small types near the duodenum can be treated through an endoscope.
Is follow-up needed after surgery?
Yes. A small risk of problems in the remaining bile ducts continues, so long-term check-ups are advised.