Ivy Yenwen Chau1, Chin Lin Perng2,3 and Gar Yang Chau1,3*
1Department of Surgery, Division of General Surgery, Taipei Veterans General Hospital, Taiwan
2Department of Internal Medicine, Division of Gastroenterology, Taipei Veterans General Hospital, Taiwan
3School of Medicine, National Yang-Ming University, Taiwan
Cystobiliary communication is a rare complication of polycystic liver disease. We present the case of a 45-year-old woman with frequent epigastric discomfort. Liver function test results revealed an elevated serum total bilirubin and elevated serum alkaline phosphatase. Computed tomography scan showed multiple cysts over left lobe liver, with an 8-cm cyst located at the hepatic hilum with downward displacement of the hepatic hilar structures. An endoscopic retrograde cholangiopancreatography revealed segmental narrowing with extrinsic compression of the bile ducts over the medial segment of the left lobe of the liver with communication of the biliary tree with the large cyst near the porta hepatic. Under the diagnosis of symptomatic polycystic liver disease with biliary communication, the patient underwent left hepatectomy. Histological examination of the surgical specimen revealed polycystic liver disease with multiple diffuse cystic lesions lined by cuboidal to flat biliary epithelium, without mesenchymal stroma or cellular atypia. After operation, patient was symptom free with normal liver function tests during follow-up. This case indicates that hepatic resection is the treatment of choice for patients with polycystic liver disease complicated with cystobiliary communication.
Chau IY, Perng CL, Chau GY. Hepatectomy for a Patient with Polycystic Liver Disease Associated with Cystobiliary Communication: A Case Report. Clin Surg. 2020; 5: 2889.