ABSTRACT
Thirty-seven patients with congenital bile duct cysts, including 17 children and nine young adults, were encountered from 1960 to April 1976. This chapter presents a remarkable paper from a relatively small city, Okayamaon on Honshu, the southern island of Japan, about 410 miles from Tokyo. All the major advances during this period in this disease were occurring in Japan, partly due of course to the Asian predisposition to choledochal malformations and it being relatively rare in the West. It was based upon the published literature to date of about 100 cases and divided choledochal cysts in three types: I, extrahepatic; II, diverticulum; and III, choledochoceles. Operative procedures were described for all the cases and reflected the surgical philosophy of the day. The paper was also influential in moving surgeons away from simple internal drainage operations, which admittedly cure the jaundice but leave lots of potential for future problems with undrained segments of cyst in direct communication typically with the duodenum.
