Cystic lesions of the bile ducts
Cystic lesions of the bile ducts (choledochal cysts) are congenital dilations of the extrahepatic or intrahepatic biliary tracts. The main danger of this pathology lies in the high risk of malignant transformation (malignancy): the probability of developing (bile duct cancer) in the cyst wall increases rapidly with age.
Causes of Cystic Lesions of the Bile Ducts
The formation of cystic lesions occurs during intrauterine development. The main cause is considered to be an anomalous pancreaticobiliary junction — a defect in the anatomical structure where the bile duct and the pancreatic duct merge outside the duodenum.
Todani Classification
Type I (50–80%): Dilation of the extrahepatic bile duct (solitary).
Ia: Cystic dilation of the entire extrahepatic duct.
Ib: Focal saccular dilation.
Ic: Fusiform dilation of the entire extrahepatic duct.
Type II (2–3%): Isolated diverticulum arising from the supraduodenal extrahepatic bile duct.
Type III (1–5%): Choledochocele; dilation limited to the intraduodenal portion of the common bile duct.
Type IV (12–35%): Multiple cysts.
IVa: Combined dilation of intrahepatic and extrahepatic bile ducts.
IVb: Multiple dilated cysts limited to the extrahepatic bile duct.
Type V (20%): Multiple intrahepatic biliary cysts, also known as Caroli's disease.
Symptoms of Cystic Lesions of the Bile Ducts
The disease can be asymptomatic for a long time and discovered incidentally. When manifested, the classic clinical picture includes a triad of symptoms (however, all three signs rarely occur simultaneously):
Pain in the right upper quadrant;
Obstructive jaundice (yellowing of the skin and sclera);
Presence of a tumor-like mass in the upper right abdomen, palpable upon examination.
Additionally, patients may complain of episodes of fever, nausea, and intolerance to fatty foods. These symptoms are often a consequence of complications such as bile stasis, stone formation within the cyst, acute cholangitis, or associated pancreatitis.
Diagnosis of Cystic Lesions of the Bile Ducts at Oberig Clinic
The diagnosis is confirmed based on laboratory and instrumental examinations:
Ultrasound examination (US) of the abdominal organs with elastography — examinations are performed on SIEMENS AG ACUSON Sequoia ultrasound systems.
Computed tomography (CT) with contrast enhancement — examinations are performed on a 128-slice SIEMENS AG CT scanner.
Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) — the clinic is equipped with the latest Vida 3 Tesla MRI machine and is a reference center for SIEMENS AG in Ukraine.
Endoscopic retrograde cholangiopancreatography (ERCP) — performed on FUJI and Olympus equipment with artificial intelligence. Oberig Clinic is a leader in implementing the latest technologies in endoscopy.
Ultrasound-guided needle biopsy performed by the expert in interventional radiology, Y. Ye. Chirkov (as indicated).
Laboratory blood tests (liver function tests, bilirubin, pancreatic amylase, tumor markers) — performed in our own certified laboratory.
Treatment of Cystic Lesions of the Bile Ducts at Oberig Clinic
There is no conservative treatment for bile duct cysts. Due to the high risk of cancer development, treatment is exclusively surgical. The standard operation is complete excision (removal) of the cyst along with the gallbladder and restoration of bile flow by creating an anastomosis between the bile duct and a loop of the small intestine (hepaticojejunostomy). For Caroli's disease (intrahepatic cysts), resection of the affected liver lobe is performed, and in case of diffuse involvement of both lobes, the only method of treatment is liver transplantation.
Why choose Oberig Clinic for the treatment of cystic lesions of the bile ducts?
Treatment Effectiveness: The success rates of surgical treatment for cystic lesions of the hepatobiliary zone meet the criteria of leading European surgical centers. If organ transplantation is required, patient survival after transplantation is over 85%.
National Leadership in Living Related Liver Transplantation: As of 1.03.2026, 212 liver transplantations have been performed on adults and children (including patients with total cystic lesions), 205 of which were from a living related donor.
Treatment Accessibility: In cases where the disease requires organ transplantation, free-of-charge transplantation is available for patients under the concluded agreement with the National Health Service of Ukraine (NHSU).
Full-Cycle Clinic: The entire necessary complex of diagnostic services (MRI, CT, US, ERCP, pathohistology) and surgical treatment, from resection to liver transplantation, is available in one clinic.
Patient Safety: Ensuring infectious monitoring at all stages of treatment.
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Online consultation appointment: https://my.oberig.ua/ru/appointment/ or call +38 044 521 30 03
