PMC3113205_01
Computed tomography reveals a liver cyst in the right lobe, measuring 16 cm in diameter.
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F1
Computed tomography indicated a cyst in the right lobe of the liver, showing homogeneous water density without any mural nodules and measuring 16 cm at its largest diameter (Figure 1).
The liver cyst protrudes extrahepatically with mild adhesion to the surrounding tissues.
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F2
At operation, the huge liver cyst was seen to protrude extrahepatically with mild adhesion to the surrounding tissue (Figure 2).
The cyst being deroofed with laparoscopic coagulating shears.
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F3
After the cyst was deroofed with laparoscopic coagulating shears (Harmonic Scalpel, Ethicon Endo-Surgery, Inc., Cincinnati, OH) (Figure 3), however, laparoscopic inspection of the inner surface of the cyst cavity revealed a small orifice of bile leakage (Figure 4).
Macroscopic inspection of the cyst cavity shows bile leakage (arrow).
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F4
After the cyst was deroofed with laparoscopic coagulating shears (Harmonic Scalpel, Ethicon Endo-Surgery, Inc., Cincinnati, OH) (Figure 3), however, laparoscopic inspection of the inner surface of the cyst cavity revealed a small orifice of bile leakage (Figure 4).
Cholangiography via the orifice (arrow) demonstrates the communication to a branch of the anterior inferior segmental duct.
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A catheter was inserted into the orifice for cholangiography, which demonstrated a communication of the cyst with the right anterior inferior hepatic branch of the bile duct (Figure 5).
The biliary orifice being closed with a laparoscopic suturing device.
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Tokyo, Japan) (Figure 6).