1. Choledochal Cyst with Annular Pancreas

2. 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

3. Imaging

4. Exposure

5. Annular Pancreas Annular pancreas Liver Duodenum

6. CDC Excision Intrapancreatic excision Intrapancreatic dissection

7. Upper margin & Reconst. RYHJ

8. 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