Table 4.
No. | Age/sex | Working diagnosis | Per-op findings | Surgical Procedure | Final diagnosis |
1 | 19/F | Haemobilia Infected hydatid cyst | SOL segment VIII 5 × 5 cm containing blood mixed purulent material, CBD dilated with clot | Segment VIII excision with CBD exploration and T-tube drainage. | Hepatic TB |
2 | 60/M | Sol liver ? possibly HCC | SOL in segment 2 and 3, enlarged LN in hepatoduodenal ligament, distended GB, dilated CBD, enlarged spleen with blackish spots | Left lateral segmentectomy with splenectomy and chlecystojejunostomy | Hepatic TB, splenic TB. |
3 | 46/M | Carcinoma GB | Mass in fundus GB, involving segment 4 of liver adherent to duodenum, multiple enlarged LN, CBD 8 mm | Enbloc resection of GB, segment IVB, V, with LN resection antrum and 1st part duodenum, GJ. | GB TB |
4 | 41/M | Haemobilia | GB thick walled with necrosed posterior wall contained clots, CBD not dilated, multiple nodules over parietal, visceral peritoneum | Cholecsytectomy with omental biopsy | GB TB |
5 | 33/F | GB polyp | GB contained polypoidal mass, few enlarged mesenteric LN, tubo-ovarian mass | Cholecystectomy and lymph node biopsy | GB TB |
6 | 35/M | Carcinoma GB with gallstones | GB contracted and thick walled, type I Mirizzi syndrome, proximal CBD dilated with multiple enlarged periportal LN, no stones in GB and CBD. | Cholecystectomy with CBD exploration with T tube drainage with LN biopsy | Periportal LN TB, Chronic cholecystitis |
7 | 70/M | Carcinoma GB | GB thickened with multiple stones, no obvious mass, CBD dilated with 1.5 cm stone, enlarged LN along periportal region | Cholecystectomy with CBD exploration with T tube drainage with Frozen section | Periportal LN TB* chronic cholecystitis |
8 | 46/F | Carcinoma head of pancreas | Large abscess cavity extending from caudate to retroduodenal area, multiple gallstones, CBD dilated 1.5 cm | Exploratory laparotomy + frozen section + cholecystectomy & Roux en y choledochojejeunostomy | Periportal LN TB* Chronic cholecystitis |
9 | 56/F | Cholangiocarcinoma | Mass in mid-CDB circumferential, encasing portal vein and right hepatic artery, multiple LN | Palliative hepaticojejunostomy, LN biopsy, CBD bx | Bile duct TB |
10 | 55/F | Cholangiocarcinoma | Mass CBD with multiple enlarged LN, confluence patent, no liver metastasis | Hepaticojejunostomy with frozen section | Periportal LN TB*bile duct no evidence of malignancy |
11 | 37/M | Pancreatitis, left sided portal hypertension, biliary stricture | Hard shrunken pancreas with multiple collaterals, splenomegaly, dilated CBD | Distal pancreatectomy, splenectomy with choledochojejunostomy | Pancreatic TB |
12 | 60/M | Periampullary carcinoma | Mass periampullary region 2 cm size, dilated CBD, small GB, few LN | Whipple pancreaticoduodenectomy with FJ | Peripancreatic LN TB |
13 | 21/M | Periampullary carcinoma | Bulky head with enlarged peripancreatic, pericholedochal, and paraduodenal LN | Whipple pancreaticoduodenectomy with FJ | Pancreatic and peripancreatic LN TB• |
14 | 30/M | Periampullary carcinoma | Mass lower end CBD, 3 × 3 cm infiltrating pancreas with dilated CBD | Whipple pancreaticoduodenectomy with FJ | Pancreatic and peripancreatic LN TB• |
* Diagnosis obtained from tissue intraoperatively from frozen section
• Tissue sent for frozen section did not provide a diagnosis