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Diagnosis and Treatment of Choledochoceles
Ryan Law, Mark Topazian Clinical Gastroenterology and Hepatology Volume 12, Issue 2, Pages (February 2014) DOI: /j.cgh Copyright © 2014 AGA Institute Terms and Conditions
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Figure 1 Anatomy of choledochoceles and duodenal duplication cysts. (A) Type A choledochocele. (B) Type B (diverticular) choledochocele. (C) Duodenal duplication cyst. Clinical Gastroenterology and Hepatology , DOI: ( /j.cgh ) Copyright © 2014 AGA Institute Terms and Conditions
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Figure 2 Endoscopic diagnosis and drainage of type A choledochocele. (A) Endoscopic view of medial wall of second portion of duodenum via a duodenoscope. Note bulging intramural segment of bile duct (asterisk) located above the ampullary orifice (arrow). (B) Cholangiography demonstrates cystic enlargement of intramural bile duct (asterisk) superior to the ampullary orifice. (C) The intramural segment of bile duct enlarges after intraductal contrast injection. (D) Appearance after endoscopic sphincterotomy. Images courtesy of Dr Todd Baron. Clinical Gastroenterology and Hepatology , DOI: ( /j.cgh ) Copyright © 2014 AGA Institute Terms and Conditions
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Figure 3 Endoscopic diagnosis and resection of type B choledochocele. (A) Endoscopic view of second portion of duodenum demonstrates a pendulous mass in the duodenal lumen (asterisk). (B) The ampullary orifice (arrow) is located proximal to the lesion. (C) Cholangiography demonstrates filling of the choledochocele (asterisk) via a narrow communication with the intra-ampullary common channel (arrow). (D) After partially deflating the lesion with an aspiration needle, a snare is positioned around the neck of the cyst. (E) Appearance after resection of the lesion (arrow points to the ampullary orifice). Adapted from Chatila et al,19 with permission from Elsevier. Clinical Gastroenterology and Hepatology , DOI: ( /j.cgh ) Copyright © 2014 AGA Institute Terms and Conditions
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