Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2023; 11(24): 5692-5699
Published online Aug 26, 2023. doi: 10.12998/wjcc.v11.i24.5692
Clinical study of extrahepatic biliary adenoma
Wei Li, Jie Tao, Xiao-Gang Song, Mei-Rong Hou, Kai Qu, Jing-Tao Gu, Xiao-Peng Yan, Bo-Wen Yao, Yuan-Fa Qin, Fang-Fang Dong, Huan-Chen Sha
Wei Li, Jie Tao, Mei-Rong Hou, Kai Qu, Jing-Tao Gu, Xiao-Peng Yan, Bo-Wen Yao, Fang-Fang Dong, Huan-Chen Sha, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Xiao-Gang Song, Yuan-Fa Qin, Fang-Fang Dong, Huan-Chen Sha, Department of Hepatobiliary Surgery, East Branch of The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: Li W, Tao J, and Sha HC contributed to manuscript writing and editing, and data collection; Li W, Tao J, Song XG, Hou MR, Qu K, Gu JT, Yan XP, Yao BW, Qin YF, and Dong FF contributed to data analysis; Sha HC contributed to conceptualization and supervision; and all authors have read and approved the final manuscript.
Supported by Natural Science Basic Research Project of Shaanxi Province, No. 2020JM-367.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Xi’an Jiaotong University the First Affiliated Hospital.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Huan-Chen Sha, MD, PhD, Chief Doctor, Professor, Surgeon, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 West Yanta Road, Xi’an 710061, Shaanxi Province, China. shahuanchen23@163.com
Received: May 30, 2023
Peer-review started: May 30, 2023
First decision: July 4, 2023
Revised: July 11, 2023
Accepted: July 28, 2023
Article in press: July 28, 2023
Published online: August 26, 2023
Processing time: 87 Days and 4.4 Hours
Abstract
BACKGROUND

Biliary adenomas that occur in the extrahepatic biliary tree are rare. It is difficult to distinguish it from cholangiocarcinoma or cholangiolithiasis by various imaging examinations, and it is very easy to be misdiagnosed.

AIM

To evaluate the cumulative experiences including clinical characteristics and treatments of nine patients diagnosed with extrahepatic biliary adenoma admitted to the First Affiliated Hospital of Xi’an Jiaotong University from 2016 to 2022.

METHODS

A total of nine patients were included in our study. The laboratory examinations, disease diagnosis, therapy and pathological characteristics, and follow-up of every patient were evaluated.

RESULTS

Our cohort consisted of six females and three males with an average diagnosis age of 65.1 years (range 46-87). Six extrahepatic biliary adenomas were located in the common bile ducts and three in the hepatic duct. On initial presentation, all of the patients have symptom of biliary origin, including obstructive jaundice (4/9, 44.4%), abdominal pain (6/9, 66.7%), and fever (3/9, 33.3%). Preoperative imaging examination considered bile duct carcinoma in 6 cases and bile duct calculi in 3 cases. All the patients received surgical treatment and were confirmed by pathology as biliary adenoma. The symptoms improved significantly in all 9 patients after surgery. Seven of nine patients recovered well at follow-up without tumor recurrence. One patient died 2 mo after the surgery due to heart failure. One patient developed jaundice again 8 mo after surgery, underwent endoscopic retrograde cholangiopancreatography and biliary stent placement.

CONCLUSION

Benign extrahepatic biliary tumors are rare and difficult to diagnosis preoperatively. Intraoperative choledochoscopy and timely biopsy may offer great advantages.

Keywords: Adenoma; Extrahepatic biliary tract; Diagnosis; Treatment

Core Tip: Biliary adenomas that occur in the extrahepatic biliary tree are rare. It is difficult to distinguish it from cholangiocarcinoma or cholangiolithiasis by various imaging examinations, and it is very easy to be misdiagnosed. In this study, we present the cumulative experiences including clinical characteristics and treatments of nine patients diagnosed with extrahepatic biliary adenoma admitted to the First Affiliated Hospital of Xi’an Jiaotong University from 2016 to 2022. Benign extrahepatic biliary tumors are rare and difficult to diagnosis preoperatively. Intraoperative choledochoscopy and timely biopsy may offer great advantages.