A 17-year-old woman presented with a 2-week history of mild abdominal pain and obstructive jaundice. She had a large, tender mass between the right costal margin and anterior superior iliac spine. MRI demonstrated a large cystic lesion which communicated with the cystic duct and was indistinguishable from the common bile duct (Fig. 1a). At laparotomy, there was a massive choledochal cyst extending from the ampulla of Vater to the bifurcation of the left and right hepatic ducts. This cyst contained 2200 ml of bile. A choledochectomy was performed en-bloc with aWhipple’s procedure (Fig. 1b). Pathological examination revealed the benign Type I choledochal cyst.
Gunn V, Adeyi O, Jhaveri K,Wei AC
Toronto General Hospital and University of Toronto, Toronto, ON, Canada