View Full Chapter Figures Only Tables Only Videos Only Print Share Email Send Email Your Name (required) Example: John Doe Email Address (required) Please enter a valid sender email address. Example: firstname.lastname@example.org CC Me Recipient Email Address (required) Separate multiple email address with semi-colons (up to 5). Subject Subject for your email. Message (Maximum characters: 1,000) Send Cancel Copyright Paragraph Text Copyright Line Text Get Citation Citation AMA Citation Doherty GM. Doherty G.M. Doherty, Gerard M.Biliary Neoplasms, Benign. In: Doherty GM. Doherty G.M. Ed. Gerard M. Doherty.eds. Quick Answers Surgery. New York, NY: McGraw-Hill; 2010. http://accesssurgery.mhmedical.com/content.aspx?bookid=853&Sectionid=49662008. Accessed January 16, 2017. MLA Citation Doherty GM. Doherty G.M. Doherty, Gerard M.. "Biliary Neoplasms, Benign." Quick Answers Surgery. Doherty GM. Doherty G.M. Ed. Gerard M. Doherty. New York, NY: McGraw-Hill, 2010, http://accesssurgery.mhmedical.com/content.aspx?bookid=853&Sectionid=49662008. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager © Copyright Tools Search Book Top Return Clip Search Book Biliary Neoplasms, Benign + Essential Features + • Gallbladder adenoma-Rare-Considered premalignant lesion-Minimal to no risk if < 1 cm• Papillomatosis: Multiple gallbladder adenomas• Adenomyomatosis: Gallbladder wall hyperplasia that can be diffuse, possibly premalignant• Leiomyomas, lipomas, hemangiomas, and heterotopic GI tissue are all other possible benign biliary neoplasms• Approximately 67% of benign biliary neoplasms are polyps, adenomatous papillomas, or bile duct adenomas; not known to have malignant potential• 47% of benign biliary neoplasms found in periampullary region and 27% found in common bile duct ++ Epidemiology + • 5% incidence of gallbladder polyps of which 50% are cholesterol polyps• < 1% incidence of benign biliary tumors + Clinical Findings ++ Symptoms and Signs + • Asymptomatic• Biliary colic or cholecystitis• Jaundice• Anorexia• Fever• Nausea ++ Laboratory Findings + • Leukocytosis if cholecystitis or cholangitis is present• Hyperbilirubinemia• Elevated alkaline phosphatase level ++ Imaging Findings + • Right upper quadrant US -Shows thickened gallbladder wall for adenomyomatosis-Shows submuscular hyperechoic areas in cholesterol polyps-Shows hyperechoic polypoid structures without shadowing for gallbladder adenomas-Shows biliary dilatation and possible stricture for benign biliary neoplasms• ERCP and percutaneous transhepatic cholangiogram (PTC) reveal stricture and proximal biliary dilatation, suggesting benign biliary neoplasms + Diagnostic Considerations ++ Rule Out + • Possible malignancy making resection often necessary to verify diagnosis + Work-up + • History and physical exam• CBC• Liver function tests• Carcinoembryonic antigen (CEA) and CA 19-9• Right upper quadrant US• PTC or ERCP + Treatment and Management ++ Surgery + • Cholecystectomy for gallbladder adenomatous polyps > 1 cm• Resection of biliary stricture and bilio-enteric reconstruction for benign biliary neoplasms causing jaundice or cholangitis ++ Complications + • Biliary leak or stricture + Resources ++ References ++Baillie J: Tumors of the gallbladder and bile ducts. J Clin Gastroenterol 1999;29:14. [PubMed: 10405225] ++Bismuth H, Majno PE: Hepatobiliary surgery. J Hepatol 2000;32(1 Suppl):208.