John A. Stauffer, MD; Frederick French, MD; Horacio Asbun, MD
Type I choledochocele are rare and surgical excision is advised due to their risk of malignancy. Minimally invasive access technique have allowed more advanced procedures to be performed with shorter hospital stay, less pain, and improved cosmesis without compromising outcomes. We present a patient undergoing laparoscopic excision of a type I choledochocele.
A 27 year old female developed biliary colic symptoms and underwent laparoscopic cholecystectomy where a dilated common bile duct was noticed. A subsequent ERCP demonstrated a type I choledochocele. She was considered a candidate for laparoscopic excision.
A totally laparoscopic excision of the extrahepatic biliary tree was performed. The distal common bile duct was transected at the level of the pancreas, the extrahepatic biliary tree was mobilized to the level of the bifurcation of the right and left hepatic ducts, and removed en bloc. Reconstruction was performed with a Roux-En-Y hepaticojejunostomy.
Minimal access approach to the surgical treatment of Type I cholecocal cyst can be performed safely and may become the procedure of choice.