Biliary Duct Hamartomas: A Systematic Review

Abstract

Biliary duct hamartomas are benign intrahepatic bile duct lesions. Despite being primarily incidental findings on imaging, these lesions can provide a diagnostic conundrum due to their shared characteristics with malignant tumors. The goal of this systematic review is to offer a thorough clinical profile of biliary duct hamartomas. There were 139 cases of biliary duct hamartomas identified in a structured systematic review of the literature. Patient demographics, clinical presentation, significant laboratory and imaging data, diagnostic modalities, treatment choices, and outcomes were all studied and reported. Biliary duct hamartomas present with mild symptoms and laboratory abnormalities, and while being visible on imaging, the results are non-specific and may require biopsy in case of red flag signs such as weight loss and a progressive increase in the size of the lesion. Furthermore, there are currently no published guidelines for the treatment of biliary duct hamartomas, and many people have had surgery despite the clinically benign nature of these abnormalities. As per the findings of the study, individuals who exhibit signs of malignancy should be investigated further. Eyeballing for red flag symptoms, followed by a specialized imaging scan and invasive treatment, is the three-step approach to biliary duct hamartomas. Since our recommendations include a shift in strategy and do not contradict existing rules, there are likely to be few roadblocks to improvement; the key barriers being technological equipment and image quality. In this study, we intended to pave the way for future research in the field. In our opinion, the next decade will bring a better understanding of the characteristics of biliary hamartomas, disease symptoms, and better recognition of any suspicious features. These indications will aid in reducing the number of unneeded surgical or invasive operations. Finally, the findings of these future studies will allow the medical community to improve and provide the best care possible.

Keywords: biliary duct hamartomas; biliary hamartomas; multiple biliary duct hamartomas; multiple biliary hamartomas; von meyenburg complexes.

Figure 1. PRISMA flow chart

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses, CINAHL: Cumulated Index to Nursing and Allied Health Literature

Figure 2. CT of the abdomen and pelvis with contrast showing 1.1 cm hypodense lesion within segment IVb

This CT image is used here in the article with written consent from the patient's legal guardian.

Figure 3. Liver parenchyma showing a well-demarcated lesion with small to medium-sized, irregularly shaped dilated glands lined by bland cuboidal epithelium with intervening fibrous stroma and surrounding inflammatory cells consistent with biliary hamartomas (H&E staining, x20)

This image is used here in the article with written consent from the patient's legal guardian. H&E: Hematoxylin and eosin