Choledochal Cyst with Annular Pancreas

History

• 45 , Female• Recurrent pain in epigastric region x 3-4 yrs• Investigations:– Biochemistry: s. amylase, s. lipase , s. Alk.pho.

Elevated s/o acute mild pancreatitis, rest NAD– USG : dilated CBD with lower end tapering and

central IHBR– MRCP: type 1 choledochal cyst

Imaging

Exposure

Annular Pancreas

Annular pancreas

Liver

Duodenum

CDC Excision

Intrapancreatic excision

Intrapancreatic dissection

Upper margin & Reconst.

RYHJ

• Post –operative course uneventful.• Patient gained 6 kg wt. over 4 months.• Follow up till date is excellent course with no

gastric outlet obstructive symptoms