Adenomas of Extrahepatic Bile Duct： Report of Two Cases and Review of the Literatures_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Bo , LIU Xubao , YAN Lnan , LI Ning

Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Bile duct tumorDiagnosisTreatment

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ObjectiveTo study the clinical manifestations, pathologic characteristics, imaging features, diagnosis and treatment of adenomas of extrahepatic bile duct.MethodsTwo cases of adenomas of extrahepatic bile duct in our hospital and 14 cases reported in the literatures were analyzed retrospectively.ResultsThe patients’(male 5, female 11) mean age was 58.4 years (range 21-85). The main manifestations included jaundice (n=11), abdominal pain (n=8),fever (n=6),dyspepsia (n=4),body weight loss (n=3) and claycolored stool (n=1). The locations of tumors were in the left hepatic duct (n=1), right hepatic duct (n=3), hepatic common bile duct(n=3）,the junction of cystic duct and common bile duct (n=1），distal common bile duct (n=8). The pathologic types were tubular adenomas (n=5), papillary (villous) adenomas (n=10),and mucous adenoma (n=1). All the patients underwent surgical therapy. The tumors were identified by postoperative histopathologic examination.ConclusionIt is difficult to correctly diagnose adenomas of extrahepatic bile duct before operation, because the clinical manifestations are usually atypical. The definite diagnosis should depend on histopathologic examination. It is the key to completely resect the tumors. Postoperative followup should be done on regular basis.

Citation： LI Bo,LIU Xubao,YAN Lnan,LI Ning. Adenomas of Extrahepatic Bile Duct： Report of Two Cases and Review of the Literatures. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2004, 11(3): 242-246. doi: Copy

1.	Harshfield DL, Teplick SK, Stanton M, et al. Obstructing villous adenoma and papillary adenomatosis of the bile ducts [Ｊ]. AJR Am J Roentgenol, 1990; 154(6)∶1217.
2.	Jennings PE, Rode J, Coral A, et al. . Villous adenoma of the common hepatic duct: the role of ultrasound in management [Ｊ]. Gut, 1990; 31（5)∶558.
3.	Doudy G, Olin WG, Shelton E, et al. Benign tumor of the extrahepatic bile ducts: reports of three cases and review of the literature [Ｊ]. Arch Surg, 1962; 85(3)∶503.
4.	Kawakatsu M, Vilgrain V, Zins M, et al. Radiology features of papillary adenoma and papillomatosis of the biliary tract [Ｊ]. Abdom Imaging, 1997; 22(1)∶87.
5.	Styne P, Warren GH, Kumpe DA, et al. Obstructive cholangitis secondary to mucus secreted by a solitary papillary bile duct tumor [Ｊ]. Gastroenterology, 1986; 90(3)∶748.
6.	Asakawa T, Terada M, Oshibuchi H, et al. Large benign polyp of the extrahepatic bile duct (mimicking bile duct cancer) [Ｊ]. Acta Med Nagasaki, 2001; 46(1)∶77.
7.	Jae HL, Chin AY, Hyo KL, et al. Radiology spectrum of intraductal papillary tumors of the bile duct [Ｊ]. Korean J Radio, 2002; 3(1)∶57.
8.	Marchal G, Gelin J, van Steenbergen W, et al. Sonographic diagnosis of intraluminal bile duct neoplasm: a report of 3 cases [Ｊ]. Gastrointest Radiol, 1984; 9(4)∶329.
9.	Seo DW, Lee SK, Yoo KS, et al. Cholangioscopic findings in bile buct tumors [Ｊ]. Gastrointest Endose, 2000; 52(5)∶630.
10.	黄洁夫主编. 胆管良性肿瘤的类型及特点. 肝脏胆道肿瘤外科学 [M]. 第1版. 北京: 人民卫生出版社， 1999∶770～773.
11.	Kim HJ, Kim MH, Lee SK, et al. Mucinhypersecreting bile duct tumor characterized by a striking homlolgy with an intraductal papillary mucinous (IPMT) tumor of the pancreas [Ｊ]. Endoscopy, 2000; 32(5)∶389.
12.	Oshikiri T, Kashimura N, Katanuma A, et al. Mucinsecreting bile duct adenomaclinicopathological resemblance to intraductal papillary mucinous tumor of the pancreas [Ｊ]. Dig Surg, 2002; 19(4)∶324.
13.	Bhathal PS, Hughes NR, Goodman ZD. The socalled bile duct adenoma is a peribiliary gland hamartoma [Ｊ]. Am J Surg Pathol, 1996; 20(7)∶858.
14.	Saxe J, Lucas C, Ledgerwood AM, et al. Villous adenoma of the common bile duct [Ｊ]. Arch Surg, 1998; 123(1)∶96.

1. Harshfield DL, Teplick SK, Stanton M, et al. Obstructing villous adenoma and papillary adenomatosis of the bile ducts [Ｊ]. AJR Am J Roentgenol, 1990; 154(6)∶1217.
2. Jennings PE, Rode J, Coral A, et al. . Villous adenoma of the common hepatic duct: the role of ultrasound in management [Ｊ]. Gut, 1990; 31（5)∶558.
3. Doudy G, Olin WG, Shelton E, et al. Benign tumor of the extrahepatic bile ducts: reports of three cases and review of the literature [Ｊ]. Arch Surg, 1962; 85(3)∶503.
4. Kawakatsu M, Vilgrain V, Zins M, et al. Radiology features of papillary adenoma and papillomatosis of the biliary tract [Ｊ]. Abdom Imaging, 1997; 22(1)∶87.
5. Styne P, Warren GH, Kumpe DA, et al. Obstructive cholangitis secondary to mucus secreted by a solitary papillary bile duct tumor [Ｊ]. Gastroenterology, 1986; 90(3)∶748.
6. Asakawa T, Terada M, Oshibuchi H, et al. Large benign polyp of the extrahepatic bile duct (mimicking bile duct cancer) [Ｊ]. Acta Med Nagasaki, 2001; 46(1)∶77.
7. Jae HL, Chin AY, Hyo KL, et al. Radiology spectrum of intraductal papillary tumors of the bile duct [Ｊ]. Korean J Radio, 2002; 3(1)∶57.
8. Marchal G, Gelin J, van Steenbergen W, et al. Sonographic diagnosis of intraluminal bile duct neoplasm: a report of 3 cases [Ｊ]. Gastrointest Radiol, 1984; 9(4)∶329.
9. Seo DW, Lee SK, Yoo KS, et al. Cholangioscopic findings in bile buct tumors [Ｊ]. Gastrointest Endose, 2000; 52(5)∶630.
10. 黄洁夫主编. 胆管良性肿瘤的类型及特点. 肝脏胆道肿瘤外科学 [M]. 第1版. 北京: 人民卫生出版社， 1999∶770～773.
11. Kim HJ, Kim MH, Lee SK, et al. Mucinhypersecreting bile duct tumor characterized by a striking homlolgy with an intraductal papillary mucinous (IPMT) tumor of the pancreas [Ｊ]. Endoscopy, 2000; 32(5)∶389.
12. Oshikiri T, Kashimura N, Katanuma A, et al. Mucinsecreting bile duct adenomaclinicopathological resemblance to intraductal papillary mucinous tumor of the pancreas [Ｊ]. Dig Surg, 2002; 19(4)∶324.
13. Bhathal PS, Hughes NR, Goodman ZD. The socalled bile duct adenoma is a peribiliary gland hamartoma [Ｊ]. Am J Surg Pathol, 1996; 20(7)∶858.
14. Saxe J, Lucas C, Ledgerwood AM, et al. Villous adenoma of the common bile duct [Ｊ]. Arch Surg, 1998; 123(1)∶96.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Adenomas of Extrahepatic Bile Duct： Report of Two Cases and Review of the Literatures

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