Diagnóstico y tratamiento del Cistoadenoma Biliar: Revisión Sistemática.

Abstract

Introduction: Hepatic cystic lesions are common, though generally benign. However, mucinous cystic neoplasms of the liver (MCN-L) represent a significant risk of malignant progression. These lesions, predominantly seen in middle-aged women, can easily be mistaken for simple cysts and are difficult to diagnose accurately with imaging alone. Objective: To synthesize evidence on the diagnosis and treatment of biliary cystadenoma, emphasizing clinical presentations, surgical strategies, and outcomes. Methodology: Following PRISMA 2020 guidelines, a PubMed search was conducted for studies published between 2015 and 2025, focusing on articles about biliary cystadenoma without documented invasive malignancy. Retrospective and single-case studies were included, excluding reviews, letters, and studies outside the time frame. Data were divided into imaging diagnosis and surgical treatment, without performing a meta-analysis due to study heterogeneity. Results: Ten studies, with more than 100 cases of biliary cystadenoma, were analyzed. CT and MRI imaging are crucial for diagnosis, although not always conclusive. Complete surgical resection is the preferred intervention, highlighting its low recurrence rate compared to conservative procedures. Discussion: The diagnosis of MCN-L primarily depends on imaging, although it is not conclusive. Complete hepatic resection offers higher success rates and lower recurrences compared to procedures like fenestration. The recommended approach is radical surgical resection for any suspicion of mucinous cystic neoplasm. Conclusion: Given the premalignant nature and diagnostic challenges of biliary cystadenoma, the safest approach is complete resection to minimize the risk of recurrence and malignant progression. More multicentric studies are needed to improve diagnostic algorithms and enhance patient selection.