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Related Experiment Videos

Smallest Todani's type II choledochal cyst.

H Yamashita1, T Otani, T Shioiri

  • 1Department of Hepato-Biliary-Pancreatic Surgery and Pathology, University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|July 23, 2003
PubMed
Summary

This report details the smallest Type II choledochal cyst, a rare bile duct dilation, successfully resected during surgery for pancreatic cancer. This case highlights a unique finding in biliary tract anomalies.

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Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Biliary Tract Diseases

Background:

  • Congenital choledochal cysts are dilations of the biliary tree, with Todani's classification widely accepted.
  • Type II choledochal cysts, characterized as a diverticulum of the common bile duct, are exceptionally rare.
  • Most reported Type II choledochal cysts are several centimeters in size.

Observation:

  • A 58-year-old male presented with jaundice, revealing a complete obstruction and a small diverticular protrusion on the common bile duct via cholangiogram.
  • Surgical resection during pancreatoduodenectomy for papillary carcinoma identified a 2 mm diameter, 5 mm depth depression on the common bile duct.
  • Microscopic examination confirmed the depression penetrated the fibromuscular layer, diagnosing it as a Todani's Type II choledochal cyst.

Findings:

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  • The resected specimen included a 2.2 x 1.7 x 1.2 cm carcinoma of the major papilla.
  • A small, 2 mm diameter and 5 mm depth, Type II choledochal cyst was identified.
  • This represents the smallest Type II choledochal cyst reported to date that was completely resected.

Implications:

  • This case expands the known spectrum of Type II choledochal cyst presentations.
  • It underscores the importance of thorough histopathological examination for identifying concurrent biliary anomalies.
  • The successful resection of this small cyst provides valuable data for surgical management strategies.