title: Computed tomography virtual endoscopy with angiographic imaging for the treatment of type IV-A choledochal cyst.
abstract: Type IV-A choledochal cysts (CCs) are a congenital biliary anomaly which involve dilatation of the extrahepatic and intrahepatic bile ducts. We present the case of a 30-year-old woman with type IV-A CC, on whom three-dimensional computed tomography (3D CT) and virtual endoscopy were performed. 3D CT revealed partial dilatation in the posterior branch of the intrahepatic bile duct and a relative stricture between it and the extrahepatic bile duct. Virtual endoscopy showed that this stricture was membrane-like and separated from the surrounding blood vessels. Based on these image findings, complete cyst resection, bile duct plasty for the stricture, and hepaticojejunostomy were safely performed. To the best of our knowledge, there are no reports of imaging by virtual endoscopy of the biliary tract which show the surrounding blood vessels running along the bile duct.
authors.affiliation: Third Department of Surgery, Tokyo Medical University, Tokyo 160-0023, Japan. akihikot@tokyo-med.ac.jp
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tsuchida
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nagakawa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kasuya
authors.forename: Bunso
authors.initials: B
authors.lastname: Kyo
authors.forename: Takahisa
authors.initials: T
authors.lastname: Ikeda
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Aoki
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
mesh_terms: D000328:Adult; D017734:Bile Ducts, Extrahepatic / Q000098:blood supply / Q000503:physiopathology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000098:blood supply / Q000503:physiopathology* / Q000601:surgery; D001662:Biliary Tract Surgical Procedures / Q000379:methods; D015529:Choledochal Cyst / Q000601:surgery*; D003952:Diagnostic Imaging / Q000379:methods; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005762:Gastroenterology / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D011247:Pregnancy; D011248:Pregnancy Complications; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome