What are the main risks associated with choledochal cysts if not excised?

Choledochal cysts, which are dilations of the bile ducts, present significant risks if left untreated. One of the critical complications associated with these cysts is the development of cholangiocarcinoma (cholangioCA), which is a malignant transformation that can occur due to chronic inflammation and irritation from bile stasis within the cyst. The risk of cholangiocarcinoma is particularly heightened in patients with choledochal cysts, making excision a crucial step in management to prevent this outcome.

In addition to the risk of cholangiocarcinoma, there's also the potential for pancreatitis. This can occur due to varying mechanisms, such as obstruction of the pancreatic duct or the impact of bile reflux on the pancreas. The presence of a choledochal cyst may cause complications in bile drainage, leading to increased pressure in the biliary tree and potential impacts on pancreatic function.

Understanding these risks underscores the importance of diagnosing and managing choledochal cysts early through surgical intervention, which not only prevents the development of cancer but also alleviates symptoms and other complications associated with the condition.