الفهرس 
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Abstract
Choledochal cyst is a rare congenital anomaly of bile ducts with high predominance in females. Five types of CC are described. Pediatric presentation includes mostly 2 features of classical triad while less occur in adults. The main imaging tools are US and MRCP while CT and ERCP are used in selected cases. Choledochal cyst is a pre-malignant condition so management should be carried out. Management evolved by cyst excision and hepaticoenterostomy which was abandoned. Many years later, other options were suggested but the reports again confirmed that excision ad hepaticoenterostmy is the treatment of choice. Type III CC is treated by ERCP and sphincterotomy. Some authors described addition of hepatectomy in cases of type IV while others prefer performance of high RYHJ. Our study included twenty one cases from the beginning of 2012 till end of 2014. Cases with proven malignancy, sepsis, cirrhosis and major cardio-pulmonary and neurological anomaly were excluded. The patients were further divided into pediatrics (being less than 18years) and adults. The peidatrics were further subcategorized into infancy (less than 2 years), childhood (2-to less than12 years) and adolescence (12- to less than 18 years). All cases were pediatrics with only one adult female. Most of pediatrics was from childhood group. Female predominance was noted.
Type I was the most common type (85%) and jaundice was the most presentation (45%). The diagnosis was achieved in 100% of cases by US while in 95% by MRCP. Only 1 case needed ERCP for diagnostic and therapeutic purposes. The adult female patient was 47 years old presented by recurrent attacks of abdominal pain and jaundice. After she sought medical advice, type II CC was noted. Excision was done with primary closure in V- manner. One year later, patient complained of repeated attacks of cholangitis and was operated for RYHJ. Surgical intervention, in the form of excision of extra-hepatic biliary system and RYHJ, was done for the rest of pediatric cases with successful outcome as only one cases needed re-exploration. None of the excised cysts proved to have malignant cells.