22 yrs male with lower CBD narrowing leading to cholangitis diagnosed in 2001
stented...bx and cytology negative..
insitu stent for 10 yrs now presented with cholangitis with stone and dilated CBD
stent, stone removed...and re stented..and Rx conservatively...
after 2 months two stents placed to dilate the lower Stricture..no e/o malignancy..
ON CECT was looking like CHOLEDOCHAL CYST ?
SURGERY: Plan: side to side bilio enteric roux en y anastomosis..
Intra op: was looking more of CDC TYPE 1 with smooth lower end tapering and dilated fusiform mid CBD..OF AROUND 3 CM..
PLAN changed and decided to remove CDC (as there are around 20% chance of development of malignancy )....AND Hepatico jejunostomy...was done....after total Excision of CDC..
Pt discharged on pod 6.
HISTOLOGY:
CARCINOMA IN SITU IN CHOLEDOCHAL CYST...NO E/O INVASION...L.N. NEGATIVE....
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