Özet:

Choledochal cysts are a congenital pathology with a malignant potential that increases with age. The preferred treatment is surgical excision in all age groups, and is now often performed laparoscopically. The aim of this case report was to emphasize the importance of biliary tumor risk when laparoscopic excision of a choledochal cyst is performed in adults. A 46-year-old woman was referred to the clinic for a type 1 choledochal cyst with an accompanying gallbladder polyp with regular margins. She had not had previous abdominal surgery and there were no co-morbidities. The patient underwent a laparoscopic cyst excision, cholecystectomy, and hepaticojejunostomy. The hepaticojejunostomy failed and the procedure was completed by converting to open surgery. The gallbladder and choledochal cysts were removed through an abdominal incision. A specimen pathology report indicated gallbladder cancer (T2N0M0). One month later, a gallbladder bed resection and perihilar lymph node dissection were performed. No malignancy was detected in the second pathology specimen. Follow-up at the postoperative 16th month revealed no difficulties. A literature review of 231 adult laparoscopic choledochal cyst excisions yielded a 2.6% risk for biliary cancers. Especially in adults, biliary tumors are more commonly associated with choledochal cysts. The cancer risk should not be forgotten during laparoscopic surgery for congenital choledochal cysts.

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