Li W, Tao J, Song XG, Hou MR, Qu K, Gu JT, Yan XP, Yao BW, Qin YF, Dong FF, Sha HC. Clinical study of extrahepatic biliary adenoma. World J Clin Cases 2023; 11(24): 5692-5699 [PMID: 37727708 DOI: 10.12998/wjcc.v11.i24.5692]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
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 byNatural 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
ARTICLE HIGHLIGHTS
Research background
Biliary adenomas occurring in extrahepatic biliary trees are rare. Various imaging tests are difficult to distinguish from cholangiocarcinoma or cholangiolithiasis.
Research motivation
As a rare benign tumor, extrahepatic biliary adenoma is very easy to be misdiagnosed.
Research objectives
To summarize the clinical characteristics and treatment experience of nine patients with extrahepatic biliary adenoma in the First Affiliated Hospital of Xi’an Jiaotong University from 2016 to 2022.
Research methods
Our study included a total of 9 patients. Laboratory examination, disease diagnosis, treatment, pathological features and follow-up of each patient were evaluated.
Research results
Our cohort included 6 women and 3 men with a mean age of diagnosis of 65.1 years (range 46-87). Six cases of extrahepatic biliary adenomas were located in the common bile duct and 3 in the hepatic duct. All patients had biliary symptoms at first, including obstructive jaundice (4/9, 44.4%), abdominal pain (6/9, 66.7%), and fever (3/9, 33.3%). Preoperative imaging showed cholangiocarcinoma in 6 cases and cholangiolithiasis in 3 cases. All patients underwent surgical treatment and were pathologically confirmed as biliary adenomas. The postoperative symptoms of all the 9 patients were significantly improved. Seven of the 9 patients recovered well after surgery without tumor recurrence. One patient died of heart failure 2 mo after surgery. Jaundice recurred in 1 patient 8 mo after surgery, and endoscopic retrograde cholangiopancreatography and biliary stent placement were performed.
Research conclusions
Benign extrahepatic biliary tumors are rare and difficult to diagnosis preoperatively. Intraoperative choledochoscopy and timely biopsy may offer great advantages.
Research perspectives
The differential diagnosis of obstructive jaundice or cholangitis should be taken into account with extrahepatic biliary adenoma. Since cholangiocarcinoma and cholangiolithiasis do not have clear clinical and imaging features to distinguish them from extrahepatic biliary adenoma, surgical interventions including cholangiographic biopsy are very effective in diagnosis and treatment.
