A Case of Peribiliary Cyst Presenting with Obstructive Jaundice

Abstract

A 77-year-old woman with a complaint of itching was shown to have an elevated serum bilirubin level. She had no history of liver disease. Computed tomography and magnetic resonance cholangiopancreatography revealed a 17-mm-diameter cystic lesion obstructing the main hepatic duct at the hepatic hilum. Drip infusion cholangiographic computed tomography and endoscopic retrograde cholangiography showed that the cyst did not communicate with the biliary tree; thus, a peribiliary cyst was diagnosed. Cystectomy was performed, and the jaundice resolved. Peribiliary cysts are generally asymptomatic and rarely cause obstructive jaundice. They are usually multiple and caused by an underlying liver disorder with a poor prognosis. Our case suggests that peribiliary cysts can arise in healthy liver and cause symptoms. Cystectomy is the treatment of choice if the cyst is solitary.

Hepatic Peribiliary Cysts with Rapidly Progressive Refractory Obstructive Jaundice and Esophageal Varices

“…For ex- ample, Otani et al described a summary of the findings of 38 Japanese HPBC patients and found that 41% exhibited an increase in the size and/or number of lesions during an average observation period of approximately four years and 16% had biliary infections, such as ascending cholangitis (4). In addition, some authors have reported cases similar to ours involving obstructive jaundice (6,14,19,20). HPBCs usually present as multiple cystic lesions along the bile ducts, with consecutive cysts tending to form relatively long segments.…”

“…HPBCs are often poorly recognized, as they are usually asymptomatic (3). However, serious cases have recently been reported in which HPBCs have induced acute cholangitis or obstructive jaundice (4)(5)(6). We herein report a case of alcoholic liver cirrhosis in which rapidly progressive HPBCs and esophageal varices developed within a very short period.…”

“…MRCP is also useful for obtaining a diagnosis of HPBC (2,17,18); however, the connection between the biliary tract and cyst cannot be distinguished. On the other hand, drip infusion cholangiography-CT (DIC-CT) is reported to be useful for differentiating these cysts from obstructive bile ducts or dilated bile ducts, such as those seen in Caroli's disease (6,9,17,18).…”

Peribiliary cysts developed in normal underlying liver: report of a case

“…In some patients, they often increase in size and number, resulting in obstructive jaundice. 7 , 8 However, peribiliary cysts are commonly known as being harmless. Until today and to the best of our knowledge, no cases of malignant degeneration have been documented so far.…”

Sclerotherapy for Peribiliary Cysts Accompanied by Biliary Stenosis

“…However, some cases are complicated by biliary stenosis, cholangitis, and obstructive jaundice (1,2). We performed sclerotherapy for peribiliary cysts and obtained good outcomes.…”