Abstract

PEREZ-ALONSO, Alejandro J. et al. Adenomyomatosis of the biliary tree, ten-year incidence and review of current literature. rev. colomb. cir. [online]. 2015, vol.30, n.2, pp.112-118. ISSN 2011-7582.

Introduction: Adenomyomatosis of the gallbladder and biliary ducts is an anatomic and medical entity of difficult diagnosis. It can be classified as generalized, segmentary or localized. Typical clinical presentation includes symptoms of cholelithiasis, but it can range from completely asymptomatic to suspicion of malignancy. The aim of this study was to review the gallbladder and intra and extrahepatic biliary ducts affectation by adenomyomatosis, its diagnosis and treatment. Patients and Method: Ten-year retrospective study, held at San Cecilio University Hospital's Digestive Surgery and Pathology Services in Granada, Spain. All patients with gallbladder and intra and extrahepatic biliary ducts adenomyomatosis were included. Results: 24 patients with adenomyomatosis were identified out of 5,141 surgical specimen in the ten-year period 2000-2010; 19 were female and five male. Twenty (83.3%) patients presented with symptoms of cholelithiasis, two (8.35%) with symptoms of cholecystitis, and two (8.35%) with obstructive signs (jaundice),all of which were consistent with the pathology findings: 20 lesions were located in the gallbladder fundus, two in the cystic duct, and two in the distal common bile duct. Laparoscopic cholecystectomy was performed in all but the last two cases, in which a cephalic pancreatico-duodenectomy, or Whipple procedure, was perfomed for suspected malignancy. Conclusion: This entity's clinical condition can present as totally asymptomatic, or with symptoms of cholelithiasis, cholecystitis, or cholestatic syndrome. When malignancy is suspected, intra-operative pathological confirmation is recommended before undertaking a complex surgical procedure.

Keywords : bile ducts; gallbladder; adenomyoma; cholecystitis; diagnosis; therapeutics.

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