Peroral cholangioscopy in Roux-en-Y hepaticojejunostomy anatomy by using the SpyGlass Direct Visualization System (with video).

摘要

Choledochal cysts are a rare congenital anomaly resulting in dilation of the intra- or extrahepatic bile ducts. Malignant transformation is a potential long-term complication1 that requires surveillance even after surgical resection.A 53-year-old woman with a history of a large, fusiform type IVa choledochal cyst (Fig. 1) underwent pan-creaticoduodenectomy with cyst resection for suspected neoplasia. A hepaticojejunostomy was created with a short common hepatic duct segment anastomosed to the bowel and proximal bifurcation of the left and right hepatic ducts. The resected cyst specimen was found to have high-grade dysplasia at the proximal bile duct margin and papillary adenoma with carcinoma in situ in the cyst wall.