Biliary ductal and vascular anomalies associated with choledochal cyst

Nineteen patients operated for choledochal cyst over a 7-year period were reviewed retrospectively. Cyst excision and Roux -en -Y hepaticojejunostomy was done in all patients but one; one patient was managed with cyst excision and an antiperistaltic hepatico-appendico-duodenostomy. About one-third of patients (6/19) had biliary ductal/vascular anomalies identified at surgery. These included anomalous right hepatic artery (n = 3), primary ductal stricture (n = 2), and aberrant right hepatic duct (n = 1). A high degree of awareness of biliary ductal and vascular anomalies is required on the part of the operating surgeon to facilitate accurate intraoperative diagnosis as well as successful reconstructive surgery.