A huge intraductal papillary neoplasm of the bile duct treated by right trisectionectomy after right portal vein embolization

Ann Hepatobiliary Pancreat Surg. 2018 May;22(2):150-155. doi: 10.14701/ahbps.2018.22.2.150. Epub 2018 May 30.

Abstract

Intraductal papillary neoplasm of the bile duct (IPNB) is a rare variant of bile duct tumors characterized by papillary growth within the bile duct lumen and recognized precursor of invasive carcinoma. IPNB was detected incidentally in a 60-year-old woman during check up. Radiologic images revealed a huge cystic mass with papillary projection and markedly dilated bile ducts. Biopsies revealed high-grade IPNB. Cholangioscopy detected a connection between the right posterior bile duct and cyst lumen with epithelial dysplasia of the bile duct. Right posterior sectional duct opened in the left hepatic duct. Consequently, right trisectionectomy and extrahepatic bile duct resection were conducted. Histological studies revealed intraductal papillary neoplasm with high-grade intraepithelial neoplasia (carcinoma in situ). IPNB patients without distant metastases are candidates for surgery and complete resection should be conducted to achieve long-term survival.

Keywords: Intraductal papillary neoplasm of the bile duct; Portal vein embolization; Right trisectionectomy.

Publication types

  • Case Reports