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From 1971 to 1990, 18 children were surgically managed for choledochal cysts at two Berlin pediatric surgical units. Eight patients underwent an internal drainage procedure, eight a Roux-en-Y hepaticojejunostomy and one a choledochoplasty. The children were followed-up 2 to 20 years later (median: 8.4 years). Three children died in the early postoperative period, but the immediate postoperative course was uneventful in all other cases. Later, five patients suffered from recurrent gastrointestinal disease, cholangitis and pancreatitis and, in two cases, from progressive liver fibrosis. Four of the five patients with symptoms had undergone internal drainage procedures; one developed cholangitis after a hepaticojejunostomy. In one case of internal drainage, the anastomosis was transformed into a hepaticojejunostomy. No patient had cancer.

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