Julietta Chang, MD, R. Matthew Walsh, MD, Kevin El-Hayek. Cleveland Clinic Foundation.
Choledochal cysts are rare congenital lesions of the biliary system. The recommended treatment is surgical excision with biliary enteric reconstruction. In patients with normal anatomy, Roux-en-Y hepaticojejunostomy is preferred. However, different options in biliary reconstruction must be entertained in those with altered anatomy. Here we present a video of the technical considerations during a hybrid laparoscopic-robotic resection of a type IVa choledochal cyst in a patient with a prior Roux-en-Y gastric bypass. The advantages of this hybrid approach of biliary resection and reconstruction are highlighted