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Intrahepatic Versus Extrahepatic Biliary Tree Cysts: Outcomes after Surgical Resection in a Multicentric Study.

Cecilia Ferrari1,2,3,4, Gian Mario D'Ambrosio2, Belen Martın2

  • 1Departamento de Ciencias Morfológicas i Quirúrgicas, Universitat autonoma de Barcelona, Barcelona, Spain.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|December 30, 2025
PubMed
Summary

Surgical resection of biliary tree cysts (BTCs) is safe and effective. Outcomes and survival rates are similar for both intrahepatic and extrahepatic BTCs, indicating location does not impact treatment success.

Keywords:
Caroli diseasebiliary treecholangiocarcinomacholedocal cystsgallbladder cancer

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Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Congenital Abnormalities

Background:

  • Biliary tree cysts (BTCs) are rare congenital bile duct dilatations.
  • BTCs increase risks of acute cholangitis and cholangiocarcinoma (CCA).
  • Surgical resection is the standard management for BTCs.

Purpose of the Study:

  • To compare surgical outcomes for intrahepatic (IHG) versus extrahepatic (EHG) BTCs.
  • To evaluate the impact of BTC location on perioperative results and long-term survival.
  • To assess the safety and feasibility of surgical resection for BTCs based on location.

Main Methods:

  • Retrospective analysis of 31 patients undergoing BTC resection (2005-2021).
  • Patients categorized into intrahepatic (IHG) and extrahepatic (EHG) groups.
  • Comparison of perioperative data, complications, oncological outcomes, and survival.

Main Results:

  • No significant differences in operative time, complications, or hospital stay between IHG and EHG.
  • Median follow-up of 68 months showed 83.9% overall survival.
  • Two patients with CCA died from disease progression; no significant survival difference by location.

Conclusions:

  • Surgical resection of BTCs is safe and feasible.
  • Perioperative outcomes and long-term survival are comparable regardless of BTC location.
  • Surgery is an effective treatment for BTCs irrespective of whether they are intrahepatic or extrahepatic.