Surgical treatment of choledochal cysts in adults: indications and current techniques
Abstract
Introduction: Choledochal cysts are rare in adults, but early diagnosis is crucial because of the risk of serious complications, including malignant transformation. Thanks to advances in diagnostic and surgical techniques, the prognosis has significantly improved.
Objective: to critically review the current evidence on the surgical treatment of choledochal cysts in adults.
Method: A review of the scientific literature was conducted using PubMed, Scielo, and Science Direct databases. The search included publications in Spanish and English from January 2015 to April 2025. A total of 83 articles were identified; after applying inclusion and exclusion criteria, 42 articles were included in the analysis, of which 35 were ultimately used as references.
Results: Choledochal cysts in adults present clinical and surgical features that differ markedly from those in children. Their classification, based on anatomical and morphological criteria, accurately guides the therapeutic approach. The treatment of choice is surgical, with techniques varying according to the type of cyst, the patient’s clinical condition, age, associated comorbidities, and the accumulated experience of the surgical team. Current surgical indications, open, laparoscopic, and robotic techniques are reviewed, along with their outcomes, complications, and recurrence rates. Recent advances, potential benefits, and persistent challenges in long-term postoperative follow-up are also discussed.
Conclusions: The surgical management of choledochal cysts in adults must be individualized according to cyst type and patient characteristics. Complete resection with biliary diversion remains the standard treatment, while minimally invasive techniques are emerging as safe and effective options in specialized centers.
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Copyright (c) 1970 Roberto Lázaro Blanco-Sosa, Jose Antonio Copo de Armas, Lenyn Daniel Montes Sevilla
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