At laparotomy, the tumour was soft and fleshy, making it difficult to palpate the margins of the lesions. Intraoperative ultrasound was therefore important for defining the extent of resection. The patient underwent an uncomplicated left hepa-tectomy (segments 2, 3 and 4) and made an uneventful recovery.
Pathology revealed a well-differentiated intrahepatic cholangiocarcinoma associated with biliary papillomatosis (BP) (Figure 2). The resection margins were positive for BP. To assess whether there was papillomatosis in the remaining intra-hepatic or extrahepatic bile ducts, postoperative endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography were performed. Neither showed evidence of a diffuse process. At the six-month follow-up, the patient was doing well, with no evidence of recurrence and complete resolution of his abdominal pain. buy ortho tri-cyclen online
Figure 2) A representative histological slide demonstrating features of ductal papilloma adjacent to a well-differentiated cholangiocarcinomaem