2.2 Treatment
With the diagnosis of cystic IPMN-B, left hepatectomy with en-block lobectomy of Spiegel caudate lobe along with the entire cyst was performed. (Figure 1c &1d) Intraoperatively the right side of the cyst wall was partially adherent to the middle hepatic vein. The left hepatic vein had a common trunk with the middle hepatic vein and was ligated subsequently after the identification. The cyst was bilobar of size 5cm x 5cm and 10cm x 10cm respectively with atrophy of the left hepatic lobe. The left hepatic duct was compressed and was seen ending blindly into the cyst. The cyst fluid was clear and mucinous.