Successful endoscopic procedures for intraductal papillary neoplasm of the bile duct: a case report.
Attention has recently been focused on biliary papillary tumors as the novel disease entity intraductal papillary neoplasm of the bile duct (IPNB), which consists of papillary proliferation of dysplastic biliary epithelium. As even benign papillary tumors are considered as premalignant, some investigators recommend aggressive surgical therapy for IPNB, although no guidelines are available to manage this disease. Few reports have described long-term follow-up of patients with benign IPNB without radical resection. If patients with IPNB who are treated only with endoscopic procedures are noted, clinical profiles and alternative therapies other than resection may be recommended. We report the case of a patient who experienced repetitive cholangitis for 10 years and was finally diagnosed with IPNB. Radical resection could not be recommended because of the age of the patient, therefore, endoscopic sphincterotomy was performed. Although an endoscopic retrograde biliary drainage catheter was placed several times for repetitive cholangitis, the patient has done well during follow-up. Our case may offer insights into the natural course and management decisions for the novel disease entity of IPNB.
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsugagun, Tochigi 321-0293, Japan.
Kohei
K
Tsuchida
Michiko
M
Yamagata
Yasuyuki
Y
Saifuku
Dan
D
Ichikawa
Kazunari
K
Kanke
Toshimitsu
T
Murohisa
Masaya
M
Tamano
Makoto
M
Iijima
Yukiko
Y
Nemoto
Wataru
W
Shimoda
Toshiaki
T
Komori
Hirokazu
H
Fukui
Kazuhito
K
Ichikawa
Hitoshi
H
Sugaya
Kazuhito
K
Miyachi
Takahiro
T
Fujimori
Hideyuki
H
Hiraishi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D002761:Cholangitis / Q000209:etiology / Q000601:surgery; D003138:Common Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004322:Drainage; D019160:Endosonography; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D010212:Papilloma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012008:Recurrence; D016717:Sphincterotomy, Endoscopic; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome