An autopsy case of obstructive jaundice due to hepatic multiple peribiliary cysts accompanying hepatolithiasis

Kai, Keita; Eguchi, Yuichiro; Kumagai, Takafumi; Sugita, Yasuo; Tokunaga, Osamu

doi:10.1111/j.1872-034x.2007.00211.x

Cited by 14 publications

(4 citation statements)

References 14 publications

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“…There have been only six reported cases in which obstructive jaundice developed, and in all six, there were multiple lesions on a background of severe liver disease with a poor prognosis. [7][8][9] In our case, the peribiliary cyst was unlike those previously reported because it was macroscopically solitary and the patient's liver was healthy. Moreover, the obstructive jaundice was successfully relieved by cystectomy, and the clinical course after surgery was uneventful.…”

Section: Discussioncontrasting

confidence: 79%

A Case of Peribiliary Cyst Presenting with Obstructive Jaundice

Ikenaga

Chijiiwa

Otani

et al. 2009

Journal of Gastrointestinal Surgery

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A 77-year-old woman with a complaint of itching was shown to have an elevated serum bilirubin level. She had no history of liver disease. Computed tomography and magnetic resonance cholangiopancreatography revealed a 17-mm-diameter cystic lesion obstructing the main hepatic duct at the hepatic hilum. Drip infusion cholangiographic computed tomography and endoscopic retrograde cholangiography showed that the cyst did not communicate with the biliary tree; thus, a peribiliary cyst was diagnosed. Cystectomy was performed, and the jaundice resolved. Peribiliary cysts are generally asymptomatic and rarely cause obstructive jaundice. They are usually multiple and caused by an underlying liver disorder with a poor prognosis. Our case suggests that peribiliary cysts can arise in healthy liver and cause symptoms. Cystectomy is the treatment of choice if the cyst is solitary.

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Section: Discussioncontrasting

confidence: 79%

A Case of Peribiliary Cyst Presenting with Obstructive Jaundice

Ikenaga

Chijiiwa

Otani

et al. 2009

Journal of Gastrointestinal Surgery

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“…Various types of cystic lesions are present in the liver, such as simple (bile duct) cyst, peribiliary cyst, adult polycystic kidney disease (APKD), Caroli's disease, echinococcal cyst, biliary cystadenoma and cystadenocarcinoma 1–3 . Recently, radiologic modalities have advanced and these lesions have become easily detectable.…”

Section: Introductionmentioning

confidence: 99%

“…V ARIOUS TYPES OF cystic lesions are present in the liver, such as simple (bile duct) cyst, peribiliary cyst, adult polycystic kidney disease (APKD), Caroli's disease, echinococcal cyst, biliary cystadenoma and cystadenocarcinoma. [1][2][3] Recently, radiologic modalities have advanced and these lesions have become easily detectable. Mesenchymal hamartoma and ciliated hepatic foregut cyst are known as hamartomatous nodules which show a cystic appearance.…”

Section: Introductionmentioning

confidence: 99%

Intrahepatic multicystic biliary hamartoma: report of a case

Kai

Takahashi²,

Miyoshi³

et al. 2008

Hepatology Research

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Multicystic biliary hamartoma is a very rare hamartomatous nodule in the liver, which has recently been described as a new category of hepatic nodular lesion. We herein report the case of a 55-year-old man histopathologically diagnosed with this entity following surgery. A solitary multilocular lesion in the liver was pointed out by ultrasonography during a systemic examination for a positive HBs antigen. This nodule could not be definitively diagnosed by radiologic modalities, including computed tomography, magnetic resonance imaging and arteriography. The patient underwent a partial resection of the posterior segment of the liver. The nodule was a localized lesion which measured 5 x 3 cm at the widest point and displayed a honeycomb appearance. Histologically, it consisted of ductal structures, periductal glands, fibrous connective tissues containing blood vessels, and bile-like materials and xanthogranulomatous inflammation within some ducts. Liver parenchyma was not present in the nodule and the bile ducts were not dilated in the background liver. The ductal epithelium expressed biliary type cytokeratins (CK7 and 19) in immunohistochemical studies. These histopathological features were consistent with multicystic biliary hamartoma, and we discuss this rare case in detail in this report.

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“…Complications related to peribiliary cysts were observed in 58 of 106 patients (55%), and biliary tract dilatation, obstructive jaundice and cholangitis were the most reported ones ( table 1 ). Other less frequent complications were noted in seven patients: hepatolithiasis (five patients), 10–14 acute pancreatitis (one patient) 15 and febrile peribiliary cysts infection (one patient). 14 Some patients had more than one complication such as obstructive jaundice and cholangitis.…”

Section: Resultsmentioning

confidence: 96%

Peribiliary cysts: a systematic review and proposal of a classification framework

Bazerbachi

Haffar²,

Sugihara

et al. 2018

BMJ Open Gastroenterol

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ObjectivePeribiliary cysts are usually benign, although severe complications and mortality may occur, and they may be confounded with other diseases. No classification delineating their different characteristics exists.DesignWe performed a systematic review of the frequency and clinical manifestations of peribiliary cysts. Two reviewers identified studies after searching multiple databases on 2 August 2017.ResultsThese cysts were prevalent in cirrhosis (9%). A total of 135 patients were reported in 72 papers with sufficient clinical data (10 countries, 65% from Japan, median age 63 years (range: 4–88), and 80% were males). Symptoms were present in 70%. Misdiagnosis occurred in 40%, and 33% underwent therapeutic misadventures. Cysts were solitary in 10%. Obstructive features and cholangitis were observed in 36% and 12.5%, respectively. Cysts progression was observed in 37.5% over a median of 18 months. Mortality was 24%, mostly due to cirrhosis. A classification framework is proposed, wherein type I includes hepatic, type II extrahepatic and type III mixed hepatic and extrahepatic cysts, each having distinct features. Specifically, type II was more frequent in females, solitary, without cirrhosis, presenting with obstructive jaundice, more difficult to diagnose and required more surgical interventions (all p<0.05).ConclusionAlthough rarely studied in the literature, peribiliary cysts were frequent in studies designed to evaluate their prevalence, and were mostly asymptomatic. Inaccurate diagnosis, therapeutic misadventures, cysts progression and cysts-related complications are frequent. In a novel classification framework based on location, extrahepatic peribiliary cysts have distinct characteristics and require a special approach for diagnosis and management.

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An autopsy case of obstructive jaundice due to hepatic multiple peribiliary cysts accompanying hepatolithiasis

Cited by 14 publications

References 14 publications

A Case of Peribiliary Cyst Presenting with Obstructive Jaundice

A Case of Peribiliary Cyst Presenting with Obstructive Jaundice

Intrahepatic multicystic biliary hamartoma: report of a case

Peribiliary cysts: a systematic review and proposal of a classification framework

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