Systematic Reviews
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2020; 12(12): 534-548
Published online Dec 27, 2020. doi: 10.4240/wjgs.v12.i12.534
Ectopic liver tissue (choristoma) on the gallbladder: A comprehensive literature review
Sami Akbulut, Khaled Demyati, Felat Ciftci, Cemalettin Koc, Adem Tuncer, Emrah Sahin, Nese Karadag, Sezai Yilmaz
Sami Akbulut, Felat Ciftci, Cemalettin Koc, Adem Tuncer, Emrah Sahin, Sezai Yilmaz, Department of Liver Transplant Institute, Inonu University, Malatya 44280, Turkey
Khaled Demyati, Department of Surgery, An-Najah National University, Nablus 11941, Palestine
Nese Karadag, Department of Pathology, Inonu University Faculty of Medicine, Malatya 44280, Turkey
Author contributions: Akbulut S, Koc C and Yilmaz S designed the report; Tuncer A, Ciftci F, Koc C, Sahin E and Akbulut S performed the literature review; Akbulut S and Demyati K organized the report and wrote the paper; Karadag N provided the histopathological information; all authors reviewed the final version.
Conflict-of-interest statement: There is no conflict of interest associated with the senior author or other coauthors who contributed to this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sami Akbulut, MD, Professor, Department of Liver Transplant Institute, Inonu University, Elazig Yolu 10. Km, Malatya 44280, Turkey. akbulutsami@gmail.com
Received: September 26, 2020
Peer-review started: September 26, 2020
First decision: October 21, 2020
Revised: November 12, 2020
Accepted: December 2, 2020
Article in press: December 2, 2020
Published online: December 27, 2020
Processing time: 86 Days and 1.3 Hours
Abstract
BACKGROUND

Liver tissue situated outside the liver with a hepatic connection is usually called an accessory liver, and that without a connection to the mother liver, is called ectopic liver tissue.

AIM

To identify studies in the literature on ectopic liver tissue located on the gallbladder surface or mesentery.

METHODS

We present two patients and review published articles on ectopic liver tissue located on the gallbladder surface accessed via PubMed, MEDLINE, Google Scholar, and Google databases. Keywords used included accessory liver lobe, aberrant liver tissue, ectopic liver tissue, ectopic liver nodule, heterotopic liver tissue, hepatic choristoma, heterotopic liver tissue on the gallbladder, and ectopic liver tissue on the gallbladder. The search included articles published before June 2020 with no language restriction. Letters to the editor, case reports, review articles, original articles, and meeting presentations were included in the search. Articles or abstracts containing adequate information on age, sex, history of liver disease, preliminary diagnosis, radiologic tools, lesion size, surgical indication, surgical procedure, and histopathological features of ectopic liver tissue were included in the study.

RESULTS

A total of 72 articles involving 91 cases of ectopic liver tissue located on the gallbladder surface or mesentery were analyzed. Of these 91 patients, 62 were female and 25 were male (no gender available for 4 patients), and the age range was 5 d to 91 years. Forty-nine patients underwent surgery for chronic cholecystitis or cholelithiasis, and 14 patients underwent surgery for acute cholecystitis. The remaining 28 patients underwent laparotomy for other reasons. Cholecystectomy was laparoscopic in 69 patients and open in 11 patients. The remaining 19 patients underwent various other surgical procedures such as autopsy, liver transplantation, living donor hepatectomy, Whipple procedure, and liver segment V resection. Histopathologically, hepatocellular carcinoma was detected in the ectopic liver tissue of one patient.

CONCLUSION

Ectopic liver tissue is a rare developmental anomaly which is usually detected incidentally. Although most studies suggest that ectopic liver located outside the gallbladder has a high risk of hepatocellular carcinoma, this is not reflected in statistical analysis.

Keywords: Liver; Gallbladder; Ectopic liver tissue; Hepatic choristoma; Histopathological features; Hepatocellular carcinoma

Core Tip: Ectopic liver tissue is a rare developmental anomaly usually detected incidentally. While it is often asymptomatic, there is a risk of malignant transformation and other complications such as bleeding and torsion. In this review, we present two cases of ectopic liver tissue located on the gallbladder surface and review published studies on ectopic liver tissue located on the gallbladder surface accessed via the PubMed, MEDLINE, Google Scholar, and Google databases. Although most studies suggest that ectopic liver located outside the gallbladder has a higher risk of hepatocellular carcinoma, this is not reflected in the statistical analysis.