title: Pure Laparoscopic Left Hemihepatectomy for Hepatic Peribiliary Cysts with Biliary Intraepithelial Neoplasia.
abstract: Introduction. Hepatic peribiliary cysts (HPCs) usually originate due to the cystic dilatation of the intrahepatic extramural peribiliary glands. We describe our rare experience of pure laparoscopic left hemihepatectomy (PLLH) in a patient with HPCs accompanied by a component of biliary intraepithelial neoplasia (BilIN). Case Presentation. A 65-year-old man was referred for further investigation of mild hepatic dysfunction. Contrast-enhanced computed tomography showed dilatation of the left-sided intrahepatic bile duct, and biliary cytology showed class III cells. The patient was highly suspected of having left side-dominated cholangiocarcinoma and underwent PLLH. Microscopic findings revealed multiple cystic dilatations of the extramural peribiliary glands; hence, this lesion was diagnosed as HPCs. The resected intrahepatic bile duct showed that the normal ductal lumen comprised low columnar epithelia; however, front formation on the BilIN was observed in some parts of the intrahepatic bile duct, indicating that the BilIN coexisted with HPCs. Conclusion. We chose surgical therapy for this patient owing to the presence of some features of biliary malignancy. We employed noble PLLH as a minimally invasive procedure for this patient.
authors.affiliation: Department of Surgery, Morioka Municipal Hospital, 5-15-1 Motomiya, Morioka 020-0866, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Umemura
authors.affiliation: Department of Surgery, Morioka Municipal Hospital, 5-15-1 Motomiya, Morioka 020-0866, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Suto
authors.affiliation: Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
authors.affiliation: Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nitta
authors.affiliation: Department of Surgery, Morioka Municipal Hospital, 5-15-1 Motomiya, Morioka 020-0866, Japan.
authors.forename: Seika
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Surgery, Morioka Municipal Hospital, 5-15-1 Motomiya, Morioka 020-0866, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Endo
authors.affiliation: Department of Anesthesiology, Morioka Municipal Hospital, 5-15-1 Motomiya, Morioka 020-8505, Japan.
authors.forename: Kazuho
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Molecular Diagnostic Pathology, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ishida