n South African Journal of Surgery - Cystic lesions of the biliary tree : proposal for a revised classification system : opinion

Volume 49, Issue 4
  • ISSN : 0038-2361
  • E-ISSN: 2078-5151



A biliary cyst is a congenital dilatation of the extrahepatic and/or intrahepatic biliary tract. It occurs in approximately 1:100 000 - 1:150 000 live births, being most common in Japan and among females. Approximately 80% of these cysts are diagnosed before the age of 10, when they classically present with a triad of right upper quadrant pain, a mass and jaundice. In adults, this triad is unusual, and abdominal pain with tenderness is usually the only initial feature. Alonso-Lej and colleagues first proposed a classification system for bile duct cysts in 1959, which was later modified by Todani and colleagues in 1977 (Fig. 1).

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