Choledochal cyst in childhood.

During a two years period, four children were operated on because of choledochal cysts. All four patients were girls aged 9, 9, 8 and 6 years at operation. The symptoms at presentation were mainly episodic abdominal pain, mild jaundice and tenderness under the right costal curvature. Ultrasonography of the biliary tract revealed a cystic dilatation of the choledochus. Endoscopic retrograde cholangiopancreatography (ERCP) confirmed the cystic dilatation and, importantly, delineated the junction of the pancreatic duct. The surgical procedure in all four patients consisted of complete excision of the choledochal cyst and extrahepatic biliary tree combined with a Roux-en-Y hepaticojejunostomy. The postoperative course of all patients was uneventful. Ultrasonography of the abdomen should be performed liberally in case of biliary tract symptoms in children.