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. 2023 Aug 26;11(24):5692-5699.
doi: 10.12998/wjcc.v11.i24.5692.

Clinical study of extrahepatic biliary adenoma

Wei Li  1 , Jie Tao  1 , Xiao-Gang Song  2 , Mei-Rong Hou  1 , Kai Qu  1 , Jing-Tao Gu  1 , Xiao-Peng Yan  1 , Bo-Wen Yao  1 , Yuan-Fa Qin  2 , Fang-Fang Dong  1   2 , Huan-Chen Sha  1   3
Affiliations

Clinical study of extrahepatic biliary adenoma

Wei Li et al. World J Clin Cases. .

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; Diagnosis; Extrahepatic biliary tract; Treatment.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Adenoma of the bile duct that mimic biliary stone disease on magnetic resonance cholangiopancreatography. A: Gallstones, the dilatation of intra- and extra-hepatic bile duct and filling defect at the end of common bile duct; B: Multiple filling defects of hilar bile duct with dilatation of intrahepatic bile duct. The arrow symbols point to the adenomas.
Figure 2
Figure 2
Adenoma of the bile duct that mimic cholangiocarcinoma on magnetic resonance cholangiopancreatography. A: A mass at the end of common bile duct with the dilatation of common bile duct; B: The mass within the left and common hepatic ducts. The arrow symbols point to adenomas.
Figure 3
Figure 3
Contrast-enhanced computed tomography scan of extrahepatic biliary adenoma. A-C: Contrast-enhanced computed tomography scan shows dilatation of the intrahepatic or extra-hepatic bile duct with a slightly enhancement of the mass in left hepatic duct (A), hilar bile duct (B) and distal common bile duct (C). The arrow symbols point to adenomas.
Figure 4
Figure 4
The macroscopic images of extrahepatic biliary adenoma. The resected specimen shows a tumor at the distal common bile duct (pancreaticoduodenectomy).
Figure 5
Figure 5
Histological examination of the resected specimen. Hematoxylin and eosin staining shows adenoma (× 200).
See this image and copyright information in PMC

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