PMC9046004_01
Magnetic resonance cholangiopancreatography finding. MRCP displays a large choledochal cyst in axial (a) and coronal (b) view of the abdomen. Cyst of the common bile duct and common hepatic duct, with partial dilatation of left and right hepatic ducts, without existing gallbladder (c).
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A magnetic resonance cholangiopancreatography (MRCP) revealed a large cystic formation of extrahepatic bile ducts with a maximum diameter of 141 mm, without a visible gallbladder, and with partial dilatation of left and right hepatic ducts (Figure 1).
Intraoperative finding of a large choledochal cyst.
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Operating field after cyst resection. Destruction of the posterior side of the pancreatic head with suppressed ventral duodenum. Common bile duct cut immediately below the hepatic ducts confluence. Biliary cannula temporarily placed in the ampulla of Vateri for intraoperative orientation (HD: hepatic ducts confluence; HA: hepatic artery; JL: jejunal loop; PH: pancreatic head; D: duodenal frame; BC: biliary cannula).
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The common bile duct was cut above the cyst and just below the confluence of the hepatic ducts (Figure 3).
Specimen of completely excised choledochal cyst.
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After complete excision of the cyst and its macroscopic examination, it was sent for histological analysis (Figure 4).
Intraoperative view of the performed Roux-en-Y pancreaticojejunostomy (on the pancreatic head defect) (JL: jejunal loop; PH: pancreatic head; D: duodenum; PJ: pancreaticojejunostomy; HDL: hepatoduodenal ligament).
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