A Resected Case Of Peribiliary Cysts With Difficult Pre-Operative Diagnosis

Abstract

A 71-year-old man who had undergone sigmoid colectomy 6 months before, was found to have dilatation of the left hepatic duct on CT and MRCP. ERC revealed a biliary stenosis of the left hepatic duct and irregular dilatations on peripheral biliary branches (B2, B3), however no mass was detected. On ultra sonography showed a tumor in B3. A left hepatic lobectmy combined with extrahepatic bile duct resection was performed, based on the diagnosis of intra hepatic cholangiocarcinoma or hepatic peribiliary cysts. The resected specimen showed multiple peribiliary cysts located around Glisson sheath and no mass was detected. Hepatic peribiliary cysts are rare and difficult to distinguish from malignant lesions. They should be considered as one of the important lesions in differential diagnoses of biliary stenosis and dilatations.