Incidenåa chistului arborelui biliar este de 1 caz la 100.000-150.000 populaåie, reprezentând circa 1% în structura patologiei cãilor
biliare. Deæi reprezintã o patologie foarte rarã care este diagnosticatã ca regulã în aproximativ 80% la copii, se asociazã cu
manifestãri clinice mai evidente la tineri æi adulåi, caracterizate prin complicaåii de caracter mecanic, infecåios sau malignizare.
Obåiunea chirurgicalã de bazã este determinatã de excizia leziunii biliare cu reconstrucåia continuitãåii biliodigestive.
Materiale æi metode: Am analizat rezultatele a 34 pacienåi spitalizaåi în Clinica Chirurgie 2 pe parcursul a 11 ani. Tipul de afectare a
arborelui biliar reprezentat conform clasificãrii Todani: tip I – 22 (64,7%) pacienåi, tip II – 5 (14,7%) pacienåi, tip III – 2 (5,8%) pacienåi,
tip IVa – 1 (2,9%) pacient, tip V – 4 (11,7%) pacienåi. Diagnosticul paraclinic a fost realizat cu utilizarea Ecografiei abdominale, TC
abdominale, Colangiopancreatografiei retrograde endoscopice (CPGRE), iar standardul de aur fiind diagnosticul prin Rezonanåã
magneticã nuclearã în regim colangiografic. Managementul chirurgical utilizat a avut drept scop realizarea decompresiei preoperatorii
biliare (25 cazuri), precum æi rezolvarea de caz la pacienåii cu chist coledocian Todani III (2 pacienåi) prin CPGRE. Colecistectomia æi
excizia chistului coledocian tip II – 2 bolnavi, Colecistectomie cu rezecåie de cale biliarã æi reconstrucåie biliodigestivã utilizând ansa
jejunalã în Y a la Roux la 26 pacienåi, un caz de rezecåie hepaticã reglatã dreaptã pentru boala Caroli cu afectarea lobului drept hepatic.
Rezultate: Au fost înregistrate complicaåii în perioada postoperatorie precoce determinate de prezenåa fistulei biliare la 3 pacienåi,
complicaåii septice 1 caz. Perioada tardivã postoperatorie evaluatã cu apariåia colangitei cronice recidivante 6 cazuri, 3 bolnavi cu
stricturã a hepaticojejunoanastomozei. Mortalitatea postoperatorie - 3%.
Concluzii: Standardul de aur în diagnosticul chisturilor arborelui biliar îl reprezintã RMN în regim colangiografic, importanåã majorã
reprezintã Ecografia abdominalã æi CPGRE. Intervenåia chirurgicalã are ca scop, pe cât posibil extirparea leziunii din cauza riscului
complicaåiilor, malignizarea fiind cea mai severã, precum æi asigurarea unui drenaj biliodigestiv adecvat.

Introduction: The incidence of biliary cysts is 1:100000 to 1:150000, accounting for approximatively 1% of all biliary tree pathology.
Although it is a very rare pathology that is diagnosed as a rule in about 80% in children, it is associated with more obvious clinical
manifestations in young and adult, characterized by complications of mechanical, infectious or malignant nature. The surgical method
of choice is removal of biliary cyst with reconstruction of biliodigestive continuity.
Materials and methods: We analyzed the results of 34 patients hospitalized in Surgery Department nr. 2 in 11 years. The type of
biliary tree damage represented by the Todani classification was: type I - 22 (64.7%) patients, type II - 5 (14.7%) patients, type III
- 2 (5.8%) patients, type IVa - 1 (2.9%) patient, type V - 4 (11.7%) patients. The diagnosis was established using Ultrasonography
(USG) of abdominal cavity, Computer tomography of abdominal cavity, Endoscopic Retrograde Cholangiopancreatography (ERCP),
and the gold standard being Magnetic Resonance Cholangiopancreatography (MRCP). The surgical management used was aimed
to achieve preoperative biliary decompression (25 cases), as well as solving the case in patients with biliary cysts type III (2 patients)
using ERCP. Cholecystectomy and excision of biliary cyst type II – 2 patients, Cholecystectomy with bile tract resection and
biliodigestive reconstruction using the Roux-en-Y hepaticojejunostomy in 26 patients, 1 case of right hepatectomy for Caroli's
disease with right lobe involvement.
Results: Early postoperative complications have been reported - biliary fistula in 3 patients, septic complications in 1 patient. Late
postoperative complications: recurrent chronic cholangitis in 6 cases, hepaticojejunostomy stricture in 3 patients. Postoperative
mortality was 3%.
Conclusions: The gold standard in diagnosis of biliary cysts is MRCP, of major importance being USG of abdominal cavity and ERCP.
The surgical treatment is aimed at removing the lesion as far as possible due to the risk of complications, malignancy being the
most severe complication, as well ensuring adequate biliodigestive drainage.