2025 Volume 61 Issue 5 Pages 812-817
A one-year-old male presented with recurrent vomiting. Image examinations revealed a cystic lesion in the duodenum, and laparotomy cholangiography was performed. Although the amylase level in the gallbladder bile was elevated to 6,048 IU/ l, no pancreaticobiliary maljunction was observed. Therefore, we performed cystic wall excision and cholecystectomy with a diagnosis of choledochocele. Postoperatively, vomiting reappeared with food intake. Since further investigations revealed duodenal stenosis, we performed secondary surgery. It showed an annular pancreas causing duodenal stenosis, which was identified at the site proximal to the original cyst excision. Subsequently, a duodeno-duodenal anastomosis was performed. Six years postsurgery, the patient remains asymptomatic, with no evidence of bile duct dilation. Choledochocele is a rare clinical entity with ongoing debate regarding its optimal management strategies. The presence or absence of a pancreaticobiliary maljunction plays a pivotal role in treatment planning, although, as demonstrated in this case, pancreatic morphological abnormalities may also be present. This report highlights our clinical experience and discusses key considerations in the management of choledochocele.
