title: Surgical strategy for mucin-producing bile duct tumor.
abstract: Tumors with copious mucin production within the intra- or extrahepatic bile ducts have been reported as mucin-producing bile duct tumors (MPBTs). Because mucin produced by these tumors causes recurrent cholangitis and obstructive jaundice, surgical resection should be indicated even if these tumors are regarded as benign. In order to choose the appropriate surgical procedure, exact preoperative assessment of tumor location and cancer extension is important, especially evaluation of the extent of superficial spreading through cholangioscopic observation and biopsy. In principle, MPBTs should be resected in a manner similar to that employed for other types of bile duct carcinomas. That is, major hepatectomy with or without extrahepatic bile duct resection or pancreaticoduodenectomy should be chosen as the surgical procedure, and intraoperative frozen section at the stumps of the bile duct is essential. On the other hand, when precise diagnosis is completed preoperatively and the lesion is diagnosed as adenoma or carcinoma with invasion confined to the ductal wall and limited superficial spreading, limited resections preserving organ functions as much as possible can be considered as a choice among surgical procedures. All ten patients with MPBT resected at our institution according to these strategies are still alive without tumor recurrence, with a median survival of 48.0 months.
authors: Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoh-ku, Chiba, 260-8670, Japan.
authors: Masayuki
authors: M
authors: Ohtsuka
authors: Fumio
authors: F
authors: Kimura
authors: Hiroaki
authors: H
authors: Shimizu
authors: Hiroyuki
authors: H
authors: Yoshidome
authors: Atsushi
authors: A
authors: Kato
authors: Hideyuki
authors: H
authors: Yoshitomi
authors: Katsunori
authors: K
authors: Furukawa
authors: Noboru
authors: N
authors: Mitsuhashi
authors: Dan
authors: D
authors: Takeuchi
authors: Tsukasa
authors: T
authors: Takayashiki
authors: Kosuke
authors: K
authors: Suda
authors: Masaru
authors: M
authors: Miyazaki
mesh_terms: D001650:Bile Duct Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic / Q000378:metabolism / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000378:metabolism / Q000473:pathology; D013505:Digestive System Surgical Procedures; D006498:Hepatectomy; D006801:Humans; D009077:Mucins / Q000378:metabolism*; D009361:Neoplasm Invasiveness; D016577:Pancreaticoduodenectomy; D011379:Prognosis
chemical_list: D009077:Mucins