Clinico-Demographic Profiling and Surgical Approaches for Choledocal Cysts: Insights from Yogyakarta

Introduction: Choledochal cysts (CCs) are rare congenital anomalies characterized by cystic dilatations in the bile ducts. This study reviews the demographic and clinical characteristics of patients diagnosed with CCs at Sardjito Hospital, Yogyakarta, Indonesia, from 2017 to 2023. Methods: A retrospective analysis of medical records was conducted, including data on demographics, symptoms, lab findings, imaging, and surgical interventions. Results: Among 29 patients, 21 were female, with an average age at diagnosis of 60.63 months. Over 50 presented with jaundice or abdominal pain. All patients underwent intraoperative cholangiogram (IOC), and 89 had magnetic resonance cholangiopancreatography (MRCP) or ultrasonography (US). The largest cyst measured 21.52 cm. Elevated levels of total bilirubin, direct bilirubin, SGOT, and SGPT were noted preoperatively. Surgical treatment involved cyst excision, with 28 patients undergoing Roux-en-Y hepaticojejunostomy and 1 patient undergoing hepaticoduodenostomy. Postoperative complications occurred in 7 patients, including two fatalities, two cases of pancreatitis, and three instances of anastomotic leakage. No significant correlations were found between clinical variables and complications. The survival rate was 93.1, with an average hospital stay of 27.4 days. Conclusion: The study highlights the female predominance of CCs, common symptoms of jaundice and abdominal pain, and the importance of IOC, MRCP, and US in diagnosis. Complete cyst excision with biliodigestive reconstruction remains the recommended treatment approach. © 2024 Universiti Putra Malaysia Press. All rights reserved.