Long‐term outcome of surgical resection for intraductal papillary neoplasm of the bile duct

Abstract

The level of invasiveness and lymph node status were found to be associated with patient survival, as was adequacy of surgery. We recommend R0 resection be attempted for patients with IPNB.

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

“…The long-term outcomes of surgically resected IPNB have recently been reported [3] , [5] , [6] , [7] , [10] , and its 5-year overall survival rate ranged from 47.0–82.0%. R1 resection, invasive carcinoma, extraductal invasion, lymphovascular invasion, lymph node metastasis, positivity for MUC1, and positivity for carcinoembryonic antigen (CEA) have been reported to be poor prognostic factors after the surgical resection of IPNB.…”

RNF43 mutation frequently occurs with GNAS mutation and mucin hypersecretion in intraductal papillary neoplasms of the bile duct

“…[4][5][6] The prognosis of IPNB depends on invasiveness, the presence of lymph node metastasis, and the completeness of surgical resection. 7,8 Overall, the survival rates of patients with IPNBs are higher than those of patients with conventional cholangiocarcinomas. 9,10 Microscopically, a predominant papillary growth pattern and varying degrees of tubular proliferation constitute the mass-forming exophytic or polypoid structures in IPNB.…”

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“…Intraductal papillary neoplasm of the bile duct consisting of multiple lesions can cause problems due to incomplete surgical resection as there is a higher chance of positive margins and recurrence in the bile duct of the remnant liver. 3,8 Resection of the whole biliary tree through liver transplant can be regarded as the only curative treatment. 9 However, the problem with this approach is that the prognosis after liver transplant is poor if the tumors harbor foci of invasive carcinoma.…”

“…The prognosis after resection of benign IPNB is far better than malignant IPNB. 2,15 Moreover, liver transplant is contraindicated when the disease progresses to invasive lesion.…”

“…1 The mainstay of IPNB treatment is surgical resection, with the goal being the eradication of all tumors. 2 Patients with biliary papillomatosis involving both lobes of the liver cannot be treated with liver resection. Therefore, the only way to cure these cases is liver transplant.…”