Obstructive Jaundice Secondary to Peribiliary Cyst Within the Common Hepatic Duct

• Published in: The American surgeon 2023-03, Vol.89 (3), p.478-480
• Main Authors: Gartland, Rajshri M., Landino, Samantha M., Liang, Norah E., Day, Celeste J., Berger, David L.
• Format: Article
• Language: English
• Subjects: Abdomen; Bile ducts; Blood; Bone marrow; Cholecystectomy; Cysts; Cysts - complications; Cysts - diagnostic imaging; Cysts - surgery; Epithelium; Erythrocytes; Hepatic Duct, Common - diagnostic imaging; Humans; Jaundice; Jaundice, Obstructive - etiology; Jaundice, Obstructive - surgery; Laparotomy; Liver; Magnetic resonance; Malignancy; Sucrose
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/0003134820973359

A magnetic resonance cholangiopancreatography (MRCP) was obtained for further evaluation and again demonstrated a large cyst (4.8 × 4.1 × 3.2 cm) of the porta hepatis thought to represent a hepatic cyst with mass effect on the common bile duct versus a choledochal cyst (Figure 1). Considering patient’s Jehovah’s Witness status and the potential for blood loss in a reoperative vascular field, the hematology service was consulted and recommended darbepoetin-alfa and IV iron sucrose preoperatively to stimulate her bone marrow to increase red blood cell production at the time of surgery. Features include a unilocular cyst lined by a single layer of columnar or cuboidal epithelium and no communication between the lumen of the bile duct and the cyst.1,2 While these are benign lesions, they may require surgical intervention if symptomatic and/or indistinguishable from choledochal cysts which can potentially harbor malignancy.