Abstract
Here we report the case of a 61-year-old man who underwent resection of peribiliary cysts that were clinically indistinguishable from intrahepatic cholangiocarcinoma. The patient was admitted to a hospital because of massive ascites and jaundice due to alcohol consumption. His symptoms were relieved by conservative treatment; however, CT revealed dilation of the left intrahepatic bile duct. The patient was subsequently referred to our hospital for further treatment. Although no mass was identified on CT, MRCP and ERC revealed translucency in a bile duct (B2+3) and significant dilation in the peripheral branches of B2 and B3, suggesting cholangiocarcinoma or biliary stenosis due to peribiliary cysts. We performed laparotomy after considering the possibility of cholangiocarcinoma. However, the final diagnosis was that of peribiliary cysts with no concomitant cancer as per intraoperative ultrasonography findings and pathological examination, and a lateral segmentectomy was performed. Although peribiliary cysts can be diagnosed using various imaging techniques, the coexistence of cholangiocarcinoma cannot be ruled out. Recent developments in imaging techniques have promoted the clinical recognition of peribiliary cysts. Furthermore, intrahepatic peribiliary glands have been reviewed from the standpoint of cholangiocarcinoma or IPNB (intraductal papillary neoplasm of the bile duct) genesis. Ours is a rare and valuable case of resected peribiliary cysts that were clinically indistinguishable from cholangicarcinoma.
