Published online Aug 26, 2023. doi: 10.12998/wjcc.v11.i24.5692
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
Biliary adenomas occurring in extrahepatic biliary trees are rare. Various imaging tests are difficult to distinguish from cholangiocarcinoma or cholangiolithiasis.
As a rare benign tumor, extrahepatic biliary adenoma is very easy to be misdiagnosed.
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.
Our study included a total of 9 patients. Laboratory examination, disease diagnosis, treatment, pathological features and follow-up of each patient were evaluated.
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.
Benign extrahepatic biliary tumors are rare and difficult to diagnosis preoperatively. Intraoperative choledochoscopy and timely biopsy may offer great advantages.
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.