Biliary cystadenomas and cystadenocarcinomas are rare cystic neoplasms that represent <5% of all hepatobiliary cystic masses and are extremely difficult to differentiate by non-invasive modalities. Aspiration of these cysts to alleviate patient symptomology and obtain a definitive diagnosis is suggested; however, due to the possibility of seeding during drainage, and with metastatic potential, aspiration is discouraged and surgical resection is recommended.

The patient presented with a possible biliary cystadenoma through inconclusive imaging. The centrally located mass obstructed visualization of the hepatic vasculature eliminating the possibility of en bloc resection.A nasal trumpet was surgically adhered to the surface and drainage was accomplished through the lumen of the trumpet. There wasno possibility of leakage, allowing for mass removal.

This innovative surgical resection of a centrally located biliary cystadenoma that obstructed visualization of the hepatic vasculature and created a difficult and potentially dangerous procedure, avoided any seeding and leaking, resulting in successful surgical removal of the biliary cystadenoma.

drainage of large abdominal cyst, resection