For types 4 and 5 choledochal cysts, what are the possible surgical options?

In the context of types 4 and 5 choledochal cysts, surgical management often involves significant considerations due to the complexity and risks associated with these lesions.

Types 4 and 5 choledochal cysts, characterized by cystic dilation of the bile ducts, often present challenges that necessitate an aggressive surgical approach. Type 4 cysts involve cystic dilation of both intrahepatic and extrahepatic bile ducts, while type 5 cysts predominantly involve intrahepatic biliary dilation (Caroli's disease).

When discussing surgical options for these types, the main focus is on ensuring adequate biliary drainage while addressing potential complications such as cholangiocarcinoma, which can arise from long-standing cystic disease. In cases of type 4 cysts where the disease is diffuse, a hepatobiliary intervention like liver transplant may become necessary, particularly if there is significant hepatic involvement or associated liver dysfunction. Hepatectomy – the surgical resection of affected liver segments – may also be pursued if resection of cystic ducts is indicated and the remaining liver is healthy.

This surgical strategy aims to remove the pathological tissue and ensure that the biliary tree is reconstructed properly to prevent future complications. In contrast, other options