Presentation of choledochal cysts without intrabiliary communication on endoscopic retrograde cholangiopancreatography.

Choledochal cysts have generally been described to communicate with the biliary system. We recently saw three adult patients in whom we could not demonstrate biliary communication between the cyst and the biliary tree, despite a carefully performed endoscopic cholangiopancreatography (ERCP). These cases may represent a variant of type II choledochal cysts. During the 5-year period of review of ERCP records, 30 choledochal cysts were diagnosed, of which 3 (10%) were the noncommunicating cases described in this report.