TY - JOUR
T1 - Enucleation of Biliary Cystadenomas
T2 - a Review
AU - Strasberg, Steven M.
AU - Chapman, William C.
N1 - Funding Information:
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.
Publisher Copyright:
© 2021, The Society for Surgery of the Alimentary Tract.
PY - 2021/10
Y1 - 2021/10
N2 - 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.
AB - 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.
KW - Biliary cystadenoma
KW - Biliary mucinous cystic neoplasm
KW - Enucleation
KW - Enucleation of hepatic cyst
KW - Hepatic cyst
KW - Liver cyst
UR - http://www.scopus.com/inward/record.url?scp=85114637120&partnerID=8YFLogxK
U2 - 10.1007/s11605-021-05106-x
DO - 10.1007/s11605-021-05106-x
M3 - Review article
C2 - 34505221
AN - SCOPUS:85114637120
SN - 1091-255X
VL - 25
SP - 2700
EP - 2706
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 10
ER -