Xing Wang1, Yun-Qiang Cai1, Yong-Hua Chen1, Xu-Bao Liu1. 1. Xing Wang, Yun-Qiang Cai, Yong-Hua Chen, Xu-Bao Liu, Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Abstract
AIM: To gain a better understanding of biliary tract intraductal papillary mucinous neoplasm (BT-IPMN). METHODS: From January 2000 to December 2013, 19 cases of BT-IPMN were retrospectively identified from a total of 343 biliary tract tumors resected in our single institution. Demographic characteristics, clinical data, pathology, surgical strategies, and long-term follow-up were analyzed. RESULTS: The mean age of the 19 BT-IPMN cases was 53.8 years (range: 25-74 years). The most common symptom was abdominal pain (15/19; 78.9%), followed by jaundice (7/19; 36.8%). Cholangitis was associated with most (16/19; 84.2%) of the BT-IPMN cases. Macroscopically visible mucin was detected in all 19 patients, based on original surgical reports. The most common abnormal preoperative imaging findings for BT-IPMN were bile duct dilation (19/19; 100%) and intraluminal masses (10/19; 52.6%). Thirteen (68.4%) cases involved the intrahepatic bile duct and hilum. We performed left hepatectomy in 11/19 (57.9%), right hepatectomy in 2/19 (10.5%), bile duct resection in 4/19 (21.1%), and pancreatoduodenectomy in 1/19 (5.3%) patients. One (5.3%) patient was biopsied and received a choledochojejunostomy because of multiple tumors involving the right extrahepatic and left intrahepatic bile ducts. Histology showed malignancy in 10/19 (52.6%) patients. The overall median survival was 68 mo. The benign cases showed a non-significant trend towards improved survival compared to malignant cases (68 mo vs 48 mo, P = 0.347). The patient without tumor resection died of liver failure 22 mo after palliative surgery. CONCLUSION: BT-IPMN is a rare biliary entity. Complete resection of the tumor is associated with good survival, even in patients with malignant disease.
AIM: To gain a better understanding of biliary tract intraductal papillary mucinous neoplasm (BT-IPMN). METHODS: From January 2000 to December 2013, 19 cases of BT-IPMN were retrospectively identified from a total of 343 biliary tract tumors resected in our single institution. Demographic characteristics, clinical data, pathology, surgical strategies, and long-term follow-up were analyzed. RESULTS: The mean age of the 19 BT-IPMN cases was 53.8 years (range: 25-74 years). The most common symptom was abdominal pain (15/19; 78.9%), followed by jaundice (7/19; 36.8%). Cholangitis was associated with most (16/19; 84.2%) of the BT-IPMN cases. Macroscopically visible mucin was detected in all 19 patients, based on original surgical reports. The most common abnormal preoperative imaging findings for BT-IPMN were bile duct dilation (19/19; 100%) and intraluminal masses (10/19; 52.6%). Thirteen (68.4%) cases involved the intrahepatic bile duct and hilum. We performed left hepatectomy in 11/19 (57.9%), right hepatectomy in 2/19 (10.5%), bile duct resection in 4/19 (21.1%), and pancreatoduodenectomy in 1/19 (5.3%) patients. One (5.3%) patient was biopsied and received a choledochojejunostomy because of multiple tumors involving the right extrahepatic and left intrahepatic bile ducts. Histology showed malignancy in 10/19 (52.6%) patients. The overall median survival was 68 mo. The benign cases showed a non-significant trend towards improved survival compared to malignant cases (68 mo vs 48 mo, P = 0.347). The patient without tumor resection died of liver failure 22 mo after palliative surgery. CONCLUSION:BT-IPMN is a rare biliary entity. Complete resection of the tumor is associated with good survival, even in patients with malignant disease.
Authors: Yoh Zen; Federica Pedica; Venkata R Patcha; Paola Capelli; Giuseppe Zamboni; Andrea Casaril; Alberto Quaglia; Yasuni Nakanuma; Nigel Heaton; Bernard Portmann Journal: Mod Pathol Date: 2011-04-22 Impact factor: 7.842
Authors: Flavio G Rocha; Hwajeong Lee; Nora Katabi; Ronald P DeMatteo; Yuman Fong; Michael I D'Angelica; Peter J Allen; David S Klimstra; William R Jarnagin Journal: Hepatology Date: 2012-08-27 Impact factor: 17.425
Authors: Thomas Schnelldorfer; Michael G Sarr; David M Nagorney; Lizhi Zhang; Thomas C Smyrk; Rui Qin; Suresh T Chari; Michael B Farnell Journal: Arch Surg Date: 2008-07
Authors: Ignacio Fuente; Marcos Gonzalez; Martin de Santibañes; Juan Pekolj; Oscar Mazza; Eduardo de Santibañes; Rodrigo Sanchez Claria Journal: J Gastrointest Cancer Date: 2019-09
Authors: T Peter Kingham; Victoria G Aveson; Alice C Wei; Jason A Castellanos; Peter J Allen; Daniel P Nussbaum; Yinin Hu; Michael I D'Angelica Journal: Curr Probl Surg Date: 2020-06-30 Impact factor: 1.909