Alcohol-related injury to peribiliary glands is a cause of peribiliary cysts: based on analysis of clinical and autopsy cases.

BACKGROUND AND GOAL: Peribiliary cysts, which are known to be associated with various hepatobiliary diseases including alcoholic liver disease, have been reported to originate in the peribiliary glands along the biliary tree. The causal relationship between the peribiliary cysts and alcohol-related hepatic and pancreatic disease were examined in this study.

METHODS AND RESULTS: Peribiliary cysts were surveyed in the radiologic reports of out-patients and in-patients at our hospital (between 2007 and 2011), and a total of 31 patients with peribiliary cysts were found; 9 patients were associated with alcoholic liver disease and 2 patients with alcoholic pancreatitis. Among 202 consecutive autopsy cases with a history of heavy drinking (chronic alcoholics) at our Department (between 1990 and 2011), peribiliary cysts were found in 29 cases (14%), and the frequency of these cysts was correlated with the degree of alcohol-related hepatic fibrosis. Interestingly, peribiliary cysts were frequently associated with adenitis of the peribiliary glands (72%), and peribiliary adenitis and cyst formation correlated well with the degree of pancreatic fibrosis.

CONCLUSIONS: These results suggest that peribiliary cysts are more likely to occur in chronic alcoholics. The frequent association of peribiliary cysts with the degree of alcohol-related hepatic fibrosis suggests the involvement of the hepatic fibrogenetic process in peribiliary cyst formation. The frequent association of peribiliary adenitis and cyst formation with the degree of pancreatic fibrosis in chronic alcoholics suggests the involvement of alcoholic injuries in the pancreas, resulting in progressive fibrosis, and peribiliary glands, resulting in adenitis and cyst formation.