Robotic-Assisted Excision of a Type I Choledochal Cyst with Hepaticoduodenostomy and Intraoperative Identification of Gallbladder Agenesis

Introduction: Choledochal cysts are rare congenital anomalies of the biliary tract, most often diagnosed in children.1 Historical management involves open cyst excision with biliary-enteric reconstruction, though minimally invasive techniques remain technically challenging due to the complexity of the anastomosis.1 Robotic-assisted surgery offers enhanced dexterity and visualization compared with laparoscopy and has gained momentum internationally.1 Gallbladder agenesis is another rare anomaly, occurring in 10–60 per 100,000 individuals.2–4 The coexistence of gallbladder agenesis and choledochal cyst is exceptionally uncommon, with only a few reported cases, including just one in a pediatric patient.2–4 We present the first pediatric case of a type I choledochal cyst with gallbladder agenesis, successfully managed with robotic-assisted excision and hepaticoduodenostomy.