Analysis Of The Diagnosis And Treatment Of Biliary Cystadenoma And Cystadenocarcinoma:Experience In11Cases And Review Of The Literature

Background:Biliary cystadenoma and cystadenocarcinoma is a rare cystic tumor of bile duct. The majority of cases arise from intrahepatic bile duct of left lobe, while very few arise from right lobe and even extrahepatic bile duct. It is prone to be misdiagnosed or wrongly treated for its rarity and nonspecific clinical and imaging manifestations.Objective:To discuss clinical features and diagnostic and treatment modalities of biliary cystadenoma and cystadenocarcinoma, thus to improve our understanding of this disease.Methods:We review and present our experience in managing11cases of patients histopathologically proven as biliary cystadenoma or cystadenocarcinoma who underwent surgical resection from October1997to May2011at our institution. Statistical analyses were performed using the SPSS17.0software. Continuous variables were compared using t test and data were correspondingly reported as means±standard deviations (SD). Categorical data were compared using chi-square test. P value of less than0.05was considered to indicate statistical significance, or<0.01indicates prominent statistical significance.Results:The group includes5cases of biliary cystadenoma and6cases of biliary cystadenocarcinoma. Female7(63.6%), age range28-70yrs old, average age53.3±1.4yrs old; male4(36.4%), age range24-78yrs old, average age60.0±2.5yrs old.5asymptomatic but with imaging occuping, and6present with some abdominal discomfort, pain or distention; only2with CA199elevated. As to imaging and preoperative diagnosis,5cases were taken as simple cysts while only2respectively as biliary cystadenoma and biliary cystadenocarcinoma, and4as possibly malignant tumors.9cases underwent complete resection and had good prognosis;1case just underwent fenestration, which resulted recurrence; and another was found widespread metastasis, which lost in touch at follow-up. The correlation between procedure strategy(radically or not) and prognosis(recurrence or not) has a prominent statistical significance.(X2(1)=10.000, P=0.002)Conclusion:Biliary cystadenoma and cystadenocarcinoma occurs mainly in middle-aged females. Clinical and imaging manifestations are nonspecific. Be more aware of detecting it when doing imaging examination, preoperative diagnosing, and operative exploring. Complete surgical resection will contribute to good prognosis.