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.

中文翻译：

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胆管囊腺瘤摘除术：综述

 背景

胆管囊腺瘤是非常罕见的良性肿瘤，可以转变为囊腺癌。最大的病例系列报告了 30 年来来自 10 个 HPB 中心的 221 例病例，即每个中心每十年约 7 例。推荐的治疗方法是肝切除术。胆管囊腺瘤的摘除术很少进行。该研究的目的是确定这些囊肿摘除的结果，特别是死亡率和复发率。

 方法

使用 OVID 进行关键词搜索，然后搜索描述胆管囊腺瘤摘除术的论文参考书目。在获得的 45 篇文章中，有 25 篇被保留。排除的主要原因是非英语语言和评论文章。

 结果

25 项研究中有 103 名患者接受了摘除术治疗。十三项研究描述了先前的治疗失败并导致复发，需要重新治疗。剜除术的主要适应症是中央较大的囊肿，肝切除术的风险很高。接受剜除术治疗的患者没有术后死亡。 13 项研究对 40 名患者进行了长期随访，考虑到肿瘤的罕见性，这一数字相当可观。没有复发或转化为恶性肿瘤。

 结论

摘除术似乎代表了 BCA 的合理治疗技术，特别是当大的囊性病变位于中央和/或需要大面积肝脏切除且实质损失显着时。