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Case Reports
. 2022 Mar 30;2022(3):rjac126.
doi: 10.1093/jscr/rjac126. eCollection 2022 Mar.

Choledochal cysts type VI: biliary cyst of the cystic duct with connecting to right anterior sectoral bile duct: a case report

Nattaporn Maneepairoj  1 , Pipit Burasakarn  1 , Anuparp Thienhiran  1 , Pusit Fuengfoo  1 , Sutdhachit Linananda  1 , Sermsak Hongjinda  1
Affiliations
Case Reports

Choledochal cysts type VI: biliary cyst of the cystic duct with connecting to right anterior sectoral bile duct: a case report

Nattaporn Maneepairoj et al. J Surg Case Rep. .

Abstract

Type VI choledochal cysts or cystic duct dilatation cysts are a relatively new and rare condition. We report the case of a 35-year-old man who presented with a history of recurrent episodes of epigastrium pain. Magnetic resonance cholangiography revealed a cyst lodged between the cystic duct and the right anterior sectoral bile duct. He underwent a laparoscopic right anterior sectorectomy with cholecystectomy. Pathological examination revealed a cyst with a fibrous wall, dense chronic inflammatory infiltration, lined by columnar epithelium. Due to its rarity, the diagnosis is often made intraoperatively. The treatment of cystic duct cysts includes cholecystectomy, complete cyst excision, recontinuity of the common bile duct. Type VI choledochal cysts are extremely rare. Preoperative diagnosis, using either magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography, is vital to prevent postoperative complications. Treatment of this type of cysts includes cholecystectomy and complete cyst excision and biliary-enteric reconstruction if necessary.

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Figures

Figure 1
Figure 1
Computed tomography image showing an intrahepatic cyst (arrow).
Figure 2
Figure 2
MRCP showing a cyst connected to the cystic duct (arrow) and the right anterior sectoral bile duct (arrowhead).
Figure 3
Figure 3
ERCP showing that the cyst can be filled with contrast from the cystic duct (arrow) and the right anterior sectoral bile duct (arrowhead).
Figure 4
Figure 4
[Left] the surgical specimen revealed that the lumen of the cyst was connected to the right anterior sectoral bile duct (arrow) and the cystic duct (arrowhead). [right] Diagram of the cystic duct cyst.
Figure 5
Figure 5
Pathological examination revealed a cyst with a fibrous wall (arrow), dense chronic inflammatory infiltration, lined by columnar epithelium (arrowhead). Mild reactive atypia, associated with marked chronic inflammatory cell infiltration, was noted. No signs of epithelial dysplasia were observed.
See this image and copyright information in PMC

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