Surgical Management of Biliary Cystadenoma with Liver Abscess — A Case by Dr. Manoj Dongare
How Recurrent Liver Abscesses Over 2 Years Were Finally Resolved with Expert Liver Surgery in Pune
When a patient suffers from recurrent liver abscesses for two long years without a clear diagnosis, it takes a sharp clinical eye and expert surgical intervention to find the real cause and treat it permanently. This is exactly what Dr. Manoj Dongare, one of the best oncologists in Pune and a leading Bile Duct Cancer Surgeon, achieved for a 40-year-old gentleman whose underlying biliary cystadenoma had gone undetected for years.
The Patient and His Medical History
A 40-year-old male patient presented with a troubling history of recurrent multiple liver abscesses in the right lobe of the liver for the past 2 years. Despite repeated treatments, the abscesses kept coming back — a clear sign that something deeper was causing the problem.
MRI of the liver revealed the root cause:
A biliary cystadenoma — a tumour of the bile duct — located in Segment V of the liver
This tumour had been silently causing repeated infections and abscess formation in the surrounding liver tissue
The patient was referred to Dr. Manoj Dongare, a highly experienced HPB Surgeon and Bile Duct Cancer Surgeon practising at D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune and Cloverleaf Speciality Clinic, Wakad, Pune-PCMC.
What is a Biliary Cystadenoma?
A biliary cystadenoma is a rare, benign but potentially dangerous tumour that arises from the bile duct lining inside the liver. It is a slow-growing tumour that can:
Cause recurrent liver infections and abscesses
Grow silently for years without obvious symptoms
Transform into cancer (cystadenocarcinoma) if left untreated
Be easily missed on routine ultrasound — requiring MRI for accurate diagnosis
In this patient's case, the biliary cystadenoma in Segment V had been the hidden cause behind two years of repeated liver abscesses — a diagnosis that was only confirmed after detailed MRI imaging.
The Surgery — Extended Right Hepatectomy with Segment Preservation
Dr. Manoj Dongare performed a carefully planned liver resection to completely remove the tumour along with the affected liver segments.
Step-by-step surgical approach:
Pre-operative planning — Detailed assessment of liver segments to plan precise resection
Resection of Segments IVB, V, and VI — Complete removal of all affected liver tissue containing the tumour and abscess
Preservation of the pedicle to Segments VII and VIII — Critically important step to maintain blood supply and bile drainage to the remaining liver
Extended right hepatectomy — Successfully completed while retaining adequate functional liver volume
Confirmation of no bile leak — Ensuring complete integrity of the biliary system after resection
The key surgical achievement here was removing the diseased segments completely while preserving the vascular and biliary pedicle to Segments VII and VIII — a technically demanding step that ensured the remaining liver functioned normally after surgery.
Post-Operative Recovery — Smooth and Uneventful
Following the expert surgery by Dr. Manoj Dongare, the patient's recovery was excellent:
No bile leak — a common and serious complication after liver resection, successfully avoided
No major post-operative complications
Patient was discharged on Day 9 in good and stable condition
Recurrent liver abscesses — which had troubled the patient for 2 full years — were completely resolved
Key Takeaways from This Case
This case successfully managed by Dr. Manoj Dongare carries important messages for patients:
Recurrent liver abscesses that keep coming back are a warning sign — the underlying cause must be investigated thoroughly
MRI is superior to ultrasound in detecting bile duct tumours like biliary cystadenoma
Biliary cystadenoma must be surgically removed — it does not resolve on its own and carries a risk of turning cancerous
HPB Surgery expertise is essential for liver resections involving multiple segments and vessel preservation
Early referral to the best oncologist in Pune with HPB expertise can prevent years of unnecessary suffering
If you or a loved one is suffering from recurrent liver abscesses or has been diagnosed with a bile duct tumour, do not delay seeking expert surgical care.
📍 Cloverleaf Speciality Clinic | Wakad, Pune-PCMC 🏥 D.Y. Patil Medical College, Hospital and Research Centre | Pimpri, Pune 🌐 📞 Call Us: +91 9881379573 🗓️ Book An Appointment →
