The Clinical Features and Strategy for Diagnosis of Choledochal Cyst Using Improved Diagnostic Techniques

Background: Choledochal cysts are rare congenital anomalies of the biliary system, presenting variably across age groups. Early diagnosis is crucial to avoid complications such as cholangitis, pancreatitis, and malignancy. Advancements in diagnostic imaging have significantly improved the detection and management of this condition. Objective: To assess the clinical features and diagnostic strategies for choledochal cysts using improved diagnostic techniques. Methodology: A retrospective observational study was conducted in the Hepato-Biliary-Pancreatic Surgery (HBPS) department of BIRDEM Hospital, Dhaka, spanning five years from January 2003 to January 2008. Thirty patients diagnosed with choledochal cysts were included based on clinical history, examination, and imaging. Data analysis was performed using SPSS version 22, with descriptive statistics and chi-square tests employed to explore associations between variables. Results: The study cohort comprised 21 females (70%) and 9 males (30%), with the majority of cases (49.5%) occurring in the 0–15 years age group. Jaundice (36%), abdominal mass (32%), and right upper quadrant pain (32%) were the most common clinical features. Complications such as cystolithiasis (24%) and pancreatitis (29%) were observed, while cirrhosis and malignancy were rare. Ultrasonography was utilized in all patients as an initial diagnostic tool, while MRCP (33%) and CT scans provided additional insights. ERCP was performed in 42% of cases, but its use has since declined due to associated risks. Conclusion: This study highlights the demographic and clinical features of choledochal cysts, with a focus on the utility of advanced imaging modalities like MRCP for non-invasive and accurate diagnosis. Early detection and intervention are key to reducing complications and improving outcomes.