Biliary cystadenoma: Short-and long-term outcome after radical hepatic resection

Francesc A. Ratti, Fabio Ferla, Michele Paganelli, Federic A. Cipriani, Luc A. Aldrighetti, Gianfranco Ferla

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

The intrahepatic biliary cystadenoma is a rare benign tumor of the liver, originating from an intrahepatic bile duct: it becomes symptomatic only when it causes obstruction of the bile duct itself. Regardless of the various diagnostic modalities available, it is difficult to distinguish preoperatively the cystadenoma both from a simple liver cyst, and from a cystic carcinoma of the bile duct. An incomplete surgical removal of the cyst often results in a higher risk of size increase and recurrence, even considering that the lesion may degenerate into a cystadenocarcinoma. Between January 2004 and May 2011, 1,173 liver resections were carried out at the Hepatobiliary Surgery Unit of San Raffaele Hospital: 12 of these were performed for cystadenoma. Forty-six patients underwent laparoscopic liver cysts deroofing: definitive histological examination in six of these patients revealed instead the diagnosis of cystadenoma. In 50% of cases, the diagnosis of cystadenoma was therefore acquired as a result of an incidental finding. The patients were all female, median age 45 years. The liver resection included six cases of left hepatectomy, three left lobectomies, and three of the right hepatectomy. The operations were performed by laparotomy, with the exception of two left lobectomies completed laparoscopically. In all cases, the postoperative course was without major complications. The resection was radical in all cases and the median hospital stay was 5 days. At a median follow-up of 16 months (range 7-30), all patients are alive and disease free. Biliary cystadenomas can easily be misunderstood and interpreted as simple hepatic cysts. Radical surgical resection is necessary and provides good shortand long-term outcomes.

Original languageEnglish
Pages (from-to)13-18
Number of pages6
JournalUpdates in Surgery
Volume64
Issue number1
DOIs
Publication statusPublished - 2012

Fingerprint

Cystadenoma
Cysts
Liver
Hepatectomy
Cystadenocarcinoma
Intrahepatic Bile Ducts
Incidental Findings
Cholestasis
Bile Ducts
Laparotomy
Length of Stay
Carcinoma
Recurrence
Neoplasms

Keywords

  • Cystadenoma
  • Incidental tumor
  • Liver cyst
  • Liver surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Biliary cystadenoma : Short-and long-term outcome after radical hepatic resection. / Ratti, Francesc A.; Ferla, Fabio; Paganelli, Michele; Cipriani, Federic A.; Aldrighetti, Luc A.; Ferla, Gianfranco.

In: Updates in Surgery, Vol. 64, No. 1, 2012, p. 13-18.

Research output: Contribution to journalArticle

Ratti, Francesc A. ; Ferla, Fabio ; Paganelli, Michele ; Cipriani, Federic A. ; Aldrighetti, Luc A. ; Ferla, Gianfranco. / Biliary cystadenoma : Short-and long-term outcome after radical hepatic resection. In: Updates in Surgery. 2012 ; Vol. 64, No. 1. pp. 13-18.
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AB - The intrahepatic biliary cystadenoma is a rare benign tumor of the liver, originating from an intrahepatic bile duct: it becomes symptomatic only when it causes obstruction of the bile duct itself. Regardless of the various diagnostic modalities available, it is difficult to distinguish preoperatively the cystadenoma both from a simple liver cyst, and from a cystic carcinoma of the bile duct. An incomplete surgical removal of the cyst often results in a higher risk of size increase and recurrence, even considering that the lesion may degenerate into a cystadenocarcinoma. Between January 2004 and May 2011, 1,173 liver resections were carried out at the Hepatobiliary Surgery Unit of San Raffaele Hospital: 12 of these were performed for cystadenoma. Forty-six patients underwent laparoscopic liver cysts deroofing: definitive histological examination in six of these patients revealed instead the diagnosis of cystadenoma. In 50% of cases, the diagnosis of cystadenoma was therefore acquired as a result of an incidental finding. The patients were all female, median age 45 years. The liver resection included six cases of left hepatectomy, three left lobectomies, and three of the right hepatectomy. The operations were performed by laparotomy, with the exception of two left lobectomies completed laparoscopically. In all cases, the postoperative course was without major complications. The resection was radical in all cases and the median hospital stay was 5 days. At a median follow-up of 16 months (range 7-30), all patients are alive and disease free. Biliary cystadenomas can easily be misunderstood and interpreted as simple hepatic cysts. Radical surgical resection is necessary and provides good shortand long-term outcomes.

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