PMC5072142_01
Endoscopic retrograde cholangiopancreatography that shows the choledochal cyst of 5.94 cm.
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PMC5072142_01_gr1.jpg
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Endoscopic retrograde cholangiopancreatography is done, finding as finding the presence of a cystic malformation of extrahepatic bile duct corresponding to a choledochal cyst type I according to the classification of Todani as well as multiple choledocholithiasis, which was resolved by the process, obtaining 3 stones 3, 5 and 9 mm and the material after the removal of purulent stones; Taking as these findings, the study continues with colangioresonancia to corroborate diagnosis, which concludes choledochal cyst type IA (Fig. 1).
Pathological piece of choledochal cyst Todani IA.
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PMC5072142_01_gr2.jpg
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Then proceed to dissection firm adhesions in bile duct and liver, with LigaSure and hemostasis proceeds to dissect bile duct, being cyst of approximately 5 x 5 cm, so fusiform extending to carina at the top and intrapancreatic part on their part lower, it dries fully behind the portal vein is achieved dissect bile duct and traction with umbilical cintilla then proceeds to dissect to carina where left hepatic duct is identified, clip is placed on the upper edge of the cyst and cut. piece choledochal cyst Todani IA is removed by umbilical port. (Fig. 2) Subsequently grape and dry bottom, jejunum-jejunal anastomosis, handle intestine is located 60 min from the angle of Treitz, cutting and grapeo of it is done, latero-lateral anastomosis, handle rises intestinal and hepato-jejunal anastomoses with 3-0 Vicryl posterior and anterior plane, hemostasis and sealing anastomosis are checked, washed and sucked cavity.