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Resection of biliary mucinous cystic neoplasms: Study of a single institutional cohort and a literature review
Background: Biliary mucinous cystic neoplasms (BMCNs) are uncommon neoplastic septated intrahepatic cysts which are often incorrectly diagnosed and have the potential for malignant transformation. Aim: The aim of this study was to assess the outcome of surgical resection of BMCNs. Methods: Data from...
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| Format: | Thesis |
| Language: | English |
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Division of Surgical Gastroenterology
2018
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| _version_ | 1867613246152769537 |
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| access_status_str | Open Access |
| author | Kloppers, Jacobus Christoffel |
| author2 | Krige, Jake E J |
| author_browse | Kloppers, Jacobus Christoffel Krige, Jake E J |
| author_facet | Krige, Jake E J Kloppers, Jacobus Christoffel |
| author_sort | Kloppers, Jacobus Christoffel |
| collection | Thesis |
| description | Background: Biliary mucinous cystic neoplasms (BMCNs) are uncommon neoplastic septated intrahepatic cysts which are often incorrectly diagnosed and have the potential for malignant transformation. Aim: The aim of this study was to assess the outcome of surgical resection of BMCNs. Methods: Data from a departmental and faculty registered prospective liver surgery database was used to identify patients who underwent surgery at Groote Schuur and the University of Cape Town Private Academic Hospitals for BMCN from 1999 to 2015. Standard demographic variables including age and gender were documented as well as detailed preoperative imaging, location and size, operative treatment, extent of resection, histology, post-operative complications using the Clavien-Dindo classification and long-term outcome. Results: Thirteen female patients (median age 45 years) had surgery. Eleven were diagnosed by computer tomography scan after investigation of abdominal pain or a palpable mass. Two were jaundiced. One cyst was found incidentally during an elective cholecystectomy. Five cysts were located centrally in the liver. Before referral three cysts were treated inappropriately with percutaneous aspiration or drainage and two were treated with operative deroofing. Six patients had anatomical liver resections and seven patients had non anatomical liver resections of which two needed ablation of residual cyst wall. One patient needed a biliary-enteric reconstruction to treat a fistula of the left hepatic duct. Median operative time was 183 minutes (range: 130-375). No invasive carcinoma was found on histology. There was no operative mortality. One surgical site infection was treated and one patient developed an intra-abdominal collection one month post-operatively. Two patients developed recurrent BMCN after 24 months. Conclusion: BMCNs should be considered in middle aged women who have well encapsulated multilocular liver cysts. Treatment of large central BMCNs adjacent to vascular and biliary structures in particular may require technically complex liver resections and are best managed in a specialized hepato-pancreatico-biliary unit. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/27400 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:05.164Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2018 |
| publishDateRange | 2018 |
| publishDateSort | 2018 |
| publisher | Division of Surgical Gastroenterology |
| publisherStr | Division of Surgical Gastroenterology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/27400 Resection of biliary mucinous cystic neoplasms: Study of a single institutional cohort and a literature review Kloppers, Jacobus Christoffel Krige, Jake E J Jonas, Eduard Surgical Gastroenterology Background: Biliary mucinous cystic neoplasms (BMCNs) are uncommon neoplastic septated intrahepatic cysts which are often incorrectly diagnosed and have the potential for malignant transformation. Aim: The aim of this study was to assess the outcome of surgical resection of BMCNs. Methods: Data from a departmental and faculty registered prospective liver surgery database was used to identify patients who underwent surgery at Groote Schuur and the University of Cape Town Private Academic Hospitals for BMCN from 1999 to 2015. Standard demographic variables including age and gender were documented as well as detailed preoperative imaging, location and size, operative treatment, extent of resection, histology, post-operative complications using the Clavien-Dindo classification and long-term outcome. Results: Thirteen female patients (median age 45 years) had surgery. Eleven were diagnosed by computer tomography scan after investigation of abdominal pain or a palpable mass. Two were jaundiced. One cyst was found incidentally during an elective cholecystectomy. Five cysts were located centrally in the liver. Before referral three cysts were treated inappropriately with percutaneous aspiration or drainage and two were treated with operative deroofing. Six patients had anatomical liver resections and seven patients had non anatomical liver resections of which two needed ablation of residual cyst wall. One patient needed a biliary-enteric reconstruction to treat a fistula of the left hepatic duct. Median operative time was 183 minutes (range: 130-375). No invasive carcinoma was found on histology. There was no operative mortality. One surgical site infection was treated and one patient developed an intra-abdominal collection one month post-operatively. Two patients developed recurrent BMCN after 24 months. Conclusion: BMCNs should be considered in middle aged women who have well encapsulated multilocular liver cysts. Treatment of large central BMCNs adjacent to vascular and biliary structures in particular may require technically complex liver resections and are best managed in a specialized hepato-pancreatico-biliary unit. 2018-02-07T12:11:21Z 2018-02-07T12:11:21Z 2017 Master Thesis Masters MPhil http://hdl.handle.net/11427/27400 eng application/pdf Division of Surgical Gastroenterology Faculty of Health Sciences University of Cape Town |
| spellingShingle | Surgical Gastroenterology Kloppers, Jacobus Christoffel Resection of biliary mucinous cystic neoplasms: Study of a single institutional cohort and a literature review |
| thesis_degree_str | Master's |
| title | Resection of biliary mucinous cystic neoplasms: Study of a single institutional cohort and a literature review |
| title_full | Resection of biliary mucinous cystic neoplasms: Study of a single institutional cohort and a literature review |
| title_fullStr | Resection of biliary mucinous cystic neoplasms: Study of a single institutional cohort and a literature review |
| title_full_unstemmed | Resection of biliary mucinous cystic neoplasms: Study of a single institutional cohort and a literature review |
| title_short | Resection of biliary mucinous cystic neoplasms: Study of a single institutional cohort and a literature review |
| title_sort | resection of biliary mucinous cystic neoplasms study of a single institutional cohort and a literature review |
| topic | Surgical Gastroenterology |
| url | http://hdl.handle.net/11427/27400 |
| work_keys_str_mv | AT kloppersjacobuschristoffel resectionofbiliarymucinouscysticneoplasmsstudyofasingleinstitutionalcohortandaliteraturereview |