PMC5338907_01
ERCP demonstrating choledochal cyst with intraluminal biliary stones.
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Another ERCP at that time revealed something it had not previously: multiple dilated central intrahepatic ducts with a grossly dilated segment of the common hepatic duct containing large biliary stones, concerning for a type Ia choledochal cyst, with proximal biliary obstruction (Fig. 1, Fig. 2).
Intra-operative photograph of choledochal cyst containing large biliary stones.
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Intra-operatively, the impressive choledochal cyst was opened and found filled with large biliary stones (Fig. 3); furthermore, a right posterior duct was identified which was included as a second anastomosis to the jejunal limb of the Roux-en-Y hepaticojejunostomy (Fig. 4).