CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(11): E1312-E1316
DOI: 10.1055/a-0743-5386
Case report
Owner and Copyright © Georg Thieme Verlag KG 2018

Single-operator cholangioscopy for diagnosis of cholangioadenoma (bile duct adenoma) and its potential impact on surgical management

John Eccles
1   Division of Gastroenterology, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Aducio Thiesen
2   Department of Anatomic Pathology, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Gurpal Sandha
1   Division of Gastroenterology, University of Alberta Hospital, Edmonton, Alberta, Canada
› Institutsangaben
Weitere Informationen

Publikationsverlauf

submitted 03. Mai 2018

accepted after revision 31. Juli 2018

Publikationsdatum:
07. November 2018 (online)

Abstract

Background and study aims Cholangioadenoma is not recognized commonly and is often only diagnosed on surgical specimens. Direct per oral single-operator cholangioscopy (SOC) allows characterization of common bile duct (CBD) lesions through direct visualization and directed forceps biopsies with potential for impacting surgical management decisions. This is a retrospective review of all SOC cases diagnosed with cholangioadenoma. Patient demographics and outcomes were recorded. Three patients (all male), average age 68 years (range 62 – 76 years), were identified to have a cholangioadenoma. The clinical indication for SOC was deranged liver enzymes with a dilated CBD and a CBD abnormality identified on biliary imaging. The site of cholangioadenoma was proximal, mid and distal CBD, respectively. All patients had a successful SOC with targeted biopsy-proven diagnosis. One patient had a synchronous cholangiocarcinoma and underwent palliative stenting whereas the other two patients underwent appropriate curative resection based on cholangioadenoma location. We conclude that SOC is safe and effective for diagnosis of cholangioadenoma and has potential impact on decisions for surgical management.

 
  • References

  • 1 Frewin CR, Robertson GS, Roberts-Thomson IC. et al. A case of an extrahepatic biliary tract fibro-adenoma in a 35-year-old woman. Aust N Z J Surg 1998; 68: 80-81
  • 2 O’Shea M, Fletcher HS, Lara JF. Villous adenoma of the extrahepatic biliary tract: a rare entity. Am Surg 2002; 68: 889-891
  • 3 Xu H, Chen L. Villous adenoma of extrahepatic bile duct: contrast-enhanced sonography findings. J Clin Ultrasound 2008; 36: 39-41
  • 4 Sotona O, Cecka F, Neoral C. et al. Papillary adenoma of the extrahepatic biliary tract - a rare cause of obstructive jaundice. Acta Gastro-enterologica Belgica 2010; 73: 270-273
  • 5 Munchi AG, Moustafa AH. Common bile duct adenoma: case report and brief review of the literature. Surg Laparosc Endosc Percutan Tech 2010; 20: e193-194
  • 6 Mavrogenis G, Deprez PH, Wallon J. et al. Bile duct adenoma causing recurrent cholangitis: diagnosis and management with targeted Spyglass access and radiofrequency ablation. Endoscopy 2012; 44: E290-E291
  • 7 Chen L, Xu MY, Chen F. Bile duct adenoma: a case report and literature review. World J Surg Oncol 2014; 12: 125
  • 8 Kim HJ, Park EK. A case of bile duct adenoma developed in hepatic hilar portion mimicking Klatskin’s tumor. HPB 2016; 18: e527-e528
  • 9 Loh KP, Nautsch D, Mueller J. et al. Adenomas involving the extrahepatic biliary tree are rare but have an aggressive clinical course. Endosc Int Open 2016; 4: E112-E117
  • 10 Seo DW, Lee SK, Yoo KS. et al. Cholangioscopic findings in bile duct tumors. Gastrointest Endosc 2000; 52: 630-634
  • 11 Chin MW, Byrne MF. Update of cholangioscopy and biliary strictures. World J Gastroenterol 2011; 17: 3864-3869