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Enucleation of Biliary Cystadenomas: a Review

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Biliary cystadenomas are very rare benign tumors which can transform into cystadenocarcinomas. The largest case series reported on 221 cases over 30 years from 10 HPB centers, i.e., about 7 cases per center per decade. The recommended treatment is liver resection. Enucleation of biliary cystadenomas has been done rarely. The purpose of the study was to determine the outcome of enucleation of these cysts, particularly the mortality rate and the recurrence rate.

Methods

A keyword search was done using OVID followed by a search of the bibliography of papers describing the enucleation of biliary cystadenomas. Of 45 articles obtained, 25 were retained. The main reasons for exclusion were non-English language and review articles.

Results

One hundred three patients in the 25 studies were treated with enucleation. Thirteen studies described prior treatments that had failed with resulting recurrence requiring re-treatment. The main indication for enucleation was large central cysts for which liver resection would be high risk. There were no postoperative deaths in patients treated by enucleation. Thirteen studies provided long-term follow-up in 40 patients, a substantial number given the rarity of the tumor. There were no recurrences or transformations to malignancy.

Conclusions

Enucleation seems to represent a reasonable treatment technique for BCA, especially when a large cystic lesion is located centrally and/or would require a large liver resection with significant loss of parenchyma.

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Acknowledgements

The authors acknowledge the advice of Dr. Sanjeev Bhalla of the Department of Radiology and Dr. Adeel Khan of the Department of Surgery, Washington University in Saint Louis, in composing figure 1 The authors also thank Dr. Deyali Chatterjee of the Department of Pathology, Washington University in Saint Louis for her help in creation of Figure 2.

Funding

Siteman Comprehensive Cancer Center and NCI Cancer Center Support Grant P30 CA091842.

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Authors and Affiliations

  1. Section of Hepato-Pancreato-Biliary Surgery, Siteman Cancer Center, Barnes-Jewish Hospital, and Washington University School of Medicine in St. Louis, St Louis, MO, USA

    Steven M. Strasberg

  2. Section of Transplantation Surgery, Siteman Cancer Center, Barnes-Jewish Hospital, and Washington University School of Medicine in St. Louis, St Louis, MO, USA

    William C. Chapman

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  1. Steven M. Strasberg
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Correspondence to Steven M. Strasberg.

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Strasberg, S.M., Chapman, W.C. Enucleation of Biliary Cystadenomas: a Review. J Gastrointest Surg 25, 2700–2706 (2021). https://doi.org/10.1007/s11605-021-05106-x

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