This case is challenging in its management and also probably the first of its kind reported. Only adrenalectomy plus hepatectomy case report available are for metastasis in which segmentectomies were done. For above reasons I would like to request the case be considered for KOPS awards category. However I am not able to decipher which category it would fall under. Kindly guide me for the same. I would in the least request a podium presentation for the same. Thanking you in anticipation

Combined Adrenalectomy for Secretory Pheochromocytoma with extended Right Hepatectomy for Choledochal Cyst- Anaesthetic Challenges.

DrJumana Haji Yousuf, Senior Consultant HPB & Transplant Anaesthesia, Department ofAnaesthesiology and Critical Care, B G S Global Hospitals, Bangalore. Abstract: Pheochromocytoma is a rare catecholamine secreting tumor arising commonly from adrenal medulla. It presents with challenging aspects during surgical resection. Choledochal cysts are congenital anomalies, which present as either isolated or combined dilatations of the extra- and intra-hepatic biliary tree. Surgical resection, pre-operative and peri-operative control of blood pressure and volume optimization are the mainstay in improving the outcome of surgery. The ideal treatment for type I and IV cysts is complete excision of the extrahepatic bile duct and restoration of biliaryenteric communication by a Roux-en-Y hepaticojejunostomy. Localized intrahepatic disease is treated effectively by appropriate hepatic resection. In type IVa cysts, if the disease is localized to a resectable portion of the liver, then the addition of segmentectomy, sectionectomy or hemihepatectomy is the ideal treatment. Case Report: A 36 yr female patient presented to our hospital with a diagnosis of Pheochromocytoma and Choledochal cyst for surgical management. After adequate preoperative evaluation and preparation the patient was scheduled to undergo combined excision of both the lesions in a single sitting. The case was managed successfully under combined Thoracic epidural and general anaesthetic technique. The surgical and anaesthetic challenges encountered and their management is discussed with a brief review of literature. A detailed literature search did not reveal any such case in past wherein a combined hepatectomy for choledochal cyst and adrenalectomy have been successfully managed. Only other such case reported are for liver metastatsis from malignant pheochromocytoma.