2017 Volume 31 Issue 2 Pages 237-245
A 60-year-old male was referred to our hospital because of a repeated cholangitis and the dilation of left intrahepatic bile duct. An abdominal computerized tomography and the magnetic resonance cholangiopancreatography revealed the presence of multiple cystic lesions and mild bile duct dilation mainly in the left hepatic lobe, and hepatic left lobe atrophy. Endoscopic retrograde cholangiography showed a biliary stenosis of the left hepatic duct and irregular dilations of peripheral biliary branches. Direct cholangioscope showed an exclusion-like stenosis was detected in the left bile duct but the tumor vessels were absent. The malignant findings were absent from the cytology in bile and the biopsy obtained from biliary stenosis. In DIC-CT no communications were present between cystic lesions and bile ducts. A left hepatic lobectomy was performed based on a provisional diagnosis of hepatic peribiliary cysts. Although hepatic peribiliary cysts are sometimes difficult to distinguish from malignant lesions, these cysts has become to be diagnosed using various imaging modalities and treated conservatively due to benign disease itself. However surgical resection is thought to be one treatment choice for HPBC with repeated cholangitis in consideration of patient background.
