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Hokuto D, Nomi T, Yasuda S, et al. Long-term observation and treatment of a widespread intraductal papillary neoplasm of the bile duct extending from the intrapancreatic bile duct to the bilateral intrahepatic bile duct: A case report. Int J Surg Case Rep. 2017;38:166-171doi: 10.1016/j.ijscr.2017.07.031.
Hokuto, D., Nomi, T., Yasuda, S., Yoshikawa, T., Ishioka, K., Yamada, T., Akahori, T., Nakagawa, K., Nagai, M., Nakamura, K., Obara, S., Kanehiro, H., & Sho, M. (2017). Long-term observation and treatment of a widespread intraductal papillary neoplasm of the bile duct extending from the intrapancreatic bile duct to the bilateral intrahepatic bile duct: A case report. International journal of surgery case reports, 38166-171. https://doi.org/10.1016/j.ijscr.2017.07.031
Hokuto, Daisuke, et al. "Long-term observation and treatment of a widespread intraductal papillary neoplasm of the bile duct extending from the intrapancreatic bile duct to the bilateral intrahepatic bile duct: A case report." International journal of surgery case reports vol. 38 (2017): 166-171. doi: https://doi.org/10.1016/j.ijscr.2017.07.031
Hokuto D, Nomi T, Yasuda S, Yoshikawa T, Ishioka K, Yamada T, Akahori T, Nakagawa K, Nagai M, Nakamura K, Obara S, Kanehiro H, Sho M. Long-term observation and treatment of a widespread intraductal papillary neoplasm of the bile duct extending from the intrapancreatic bile duct to the bilateral intrahepatic bile duct: A case report. Int J Surg Case Rep. 2017;38:166-171. doi: 10.1016/j.ijscr.2017.07.031. Epub 2017 Jul 23. PMID: 28763696; PMCID: PMC5536823.
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Int J Surg Case Rep. 2017;38:166-171. doi: 10.1016/j.ijscr.2017.07.031. Epub 2017 Jul 23.

Long-term observation and treatment of a widespread intraductal papillary neoplasm of the bile duct extending from the intrapancreatic bile duct to the bilateral intrahepatic bile duct: A case report.

International journal of surgery case reports

Daisuke Hokuto, Takeo Nomi, Satoshi Yasuda, Takahiro Yoshikawa, Kohei Ishioka, Takatsugu Yamada, Takahiro Akahori, Kenji Nakagawa, Minako Nagai, Kota Nakamura, Shinsaku Obara, Hiromichi Kanehiro, Masayuki Sho

Affiliations

  1. Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan. Electronic address: [email protected].
  2. Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan.

PMID: 28763696 PMCID: PMC5536823 DOI: 10.1016/j.ijscr.2017.07.031

Abstract

INTRODUCTION: Few studies have reported the long-term outcomes of surgical resected intraductal papillary neoplasm of the bile duct (IPNB). Here, we describe the long-term observation and treatment of a case of widespread IPNB.

PRESENTATION OF CASE: A 57-year-old male was referred to our hospital due to jaundice and dilation of the intrahepatic bile duct. Computed tomography showed dilation and irregularities of the right intrahepatic and extrahepatic bile ducts together with a 3cm nodule in the common hepatic duct. Peroral cholangioscopy revealed mucinous discharge from the ampulla of Vater, which resulted in a diagnosis of IPNB. A biopsy of the nodule and the bile duct revealed papillary adenoma in all of them. Right hepatectomy, caudate lobectomy, extrahepatic bile duct resection, and left hepaticojejunostomy were performed. The nodule was histologically diagnosed as papillary carcinoma in situ, and R0 resection was performed. However, mucus production from the papillary adenoma in the B3 and B4 was observed. We carefully managed the patient's biliary tract by inserting a biliary drainage tube into the segment 2, and he has survived for more than 7 years since the initial treatment.

DISCUSSION: Mucus might be produced after the surgical resection of IPNB even if s surgical margin was benign. Five-year survival rate of benign IPNB was reported from 85% to 100%. That might be caused by difference of the postoperative management of the biliary tract.

CONCLUSIONS: Careful management of the biliary tract should be performed after surgical resection of IPNB.

Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Keywords: Case report; IPNB; Intrahepatic papillary neoplasm of the bile duct; PTBD; Percutaneous transhepatic bile duct drainage; Refractory cholangitis

References

  1. Hepatology. 2012 Oct;56(4):1352-60 - PubMed
  2. J Hepatol. 2012 Oct;57(4):787-93 - PubMed
  3. J Gastroenterol Hepatol. 2017 Feb;32(2):527-533 - PubMed
  4. Int J Surg. 2016 Mar;27:187-9 - PubMed
  5. Hepatology. 2006 Nov;44(5):1333-43 - PubMed
  6. J Gastrointest Surg. 2016 Jul;20(7):1368-75 - PubMed
  7. Am J Gastroenterol. 2012 Jan;107(1):118-25 - PubMed
  8. J Surg Oncol. 2008 May 1;97(6):508-12 - PubMed
  9. Ann Surg. 2016 Apr;263(4):656-63 - PubMed
  10. Int J Surg. 2016 Oct;34:180-186 - PubMed
  11. J Hepatobiliary Pancreat Sci. 2014 Mar;21(3):176-85 - PubMed
  12. Int J Surg Case Rep. 2015;12:123-7 - PubMed

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