胆管错构瘤:一项系统评价

Biliary Duct Hamartomas: A Systematic Review.

作者信息

Sheikh Abdul Ahad E, Nguyen Anthony P, Leyba Katarina, Javed Nismat, Shah Sana, Deradke Alexander, Cormier Christopher, Shekhar Rahul, Sheikh Abu Baker

机构信息

Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, USA.

Internal Medicine, University of New Mexico School of Medicine, Albuquerque, USA.

出版信息

Cureus. 2022 May 26;14(5):e25361. doi: 10.7759/cureus.25361. eCollection 2022 May.

Abstract

Biliary duct hamartomas are benign intrahepatic bile duct lesions. Despite being primarily incidental findings on imaging, these lesions can provide a diagnostic conundrum due to their shared characteristics with malignant tumors. The goal of this systematic review is to offer a thorough clinical profile of biliary duct hamartomas. There were 139 cases of biliary duct hamartomas identified in a structured systematic review of the literature. Patient demographics, clinical presentation, significant laboratory and imaging data, diagnostic modalities, treatment choices, and outcomes were all studied and reported. Biliary duct hamartomas present with mild symptoms and laboratory abnormalities, and while being visible on imaging, the results are non-specific and may require biopsy in case of red flag signs such as weight loss and a progressive increase in the size of the lesion. Furthermore, there are currently no published guidelines for the treatment of biliary duct hamartomas, and many people have had surgery despite the clinically benign nature of these abnormalities. As per the findings of the study, individuals who exhibit signs of malignancy should be investigated further. Eyeballing for red flag symptoms, followed by a specialized imaging scan and invasive treatment, is the three-step approach to biliary duct hamartomas. Since our recommendations include a shift in strategy and do not contradict existing rules, there are likely to be few roadblocks to improvement; the key barriers being technological equipment and image quality. In this study, we intended to pave the way for future research in the field. In our opinion, the next decade will bring a better understanding of the characteristics of biliary hamartomas, disease symptoms, and better recognition of any suspicious features. These indications will aid in reducing the number of unneeded surgical or invasive operations. Finally, the findings of these future studies will allow the medical community to improve and provide the best care possible.

摘要

胆管错构瘤是肝脏内的良性胆管病变。尽管这些病变主要是在影像学检查中偶然发现的,但由于它们与恶性肿瘤具有共同特征,可能会带来诊断难题。本系统评价的目的是提供胆管错构瘤全面的临床概况。在对文献进行的结构化系统评价中,共识别出139例胆管错构瘤病例。对患者的人口统计学特征、临床表现、重要的实验室和影像学数据、诊断方法、治疗选择及结果均进行了研究和报告。胆管错构瘤症状较轻且实验室检查有异常,虽然在影像学上可见,但结果不具特异性,对于出现体重减轻和病变大小逐渐增加等警示体征的情况,可能需要进行活检。此外,目前尚无关于胆管错构瘤治疗的已发表指南,尽管这些异常在临床上为良性,但许多人还是接受了手术。根据研究结果,出现恶性迹象的个体应进一步检查。留意警示症状,随后进行专门的影像学扫描和侵入性治疗,是针对胆管错构瘤的三步法。由于我们的建议包括策略转变且不与现有规则相矛盾,因此改进过程可能几乎没有障碍;关键障碍在于技术设备和图像质量。在本研究中,我们旨在为该领域的未来研究铺平道路。我们认为,未来十年将能更好地了解胆管错构瘤的特征、疾病症状,并能更好地识别任何可疑特征。这些指征将有助于减少不必要的手术或侵入性操作的数量。最后,这些未来研究的结果将使医学界得以改进并提供尽可能最佳的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/762a/9236677/7eec128b7690/cureus-0014-00000025361-i01.jpg

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