Clinical Presentation

A 61-year-old man presents with biliary obstruction after Roux-en-Y biliary reconstruction for cholangiocarcinoma.

(A,B) Contrast-enhanced computed tomographic (CT) scan shows a softtissue mass (arrow) adjacent to the Roux limb (arrowhead). (C) Percutaneous cholangiogram shows central biliary obstruction (arrow). A biliary drain was placed for 3 days to decompress the bile ducts before stent placement. (D) Successful placement of stent (arrow) across the extrahepatic duct.

Differential Diagnosis