title: Biliary tract intraductal papillary mucinous neoplasm: report of 19 cases.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  BT-IPMN is a rare biliary entity. Complete resection of the tumor is associated with good survival, even in patients with malignant disease.
authors.affiliation: 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.
authors.forename: Xing
authors.initials: X
authors.lastname: Wang
authors.affiliation: 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.
authors.forename: Yun-Qiang
authors.initials: YQ
authors.lastname: Cai
authors.affiliation: 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.
authors.forename: Yong-Hua
authors.initials: YH
authors.lastname: Chen
authors.affiliation: 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.
authors.forename: Xu-Bao
authors.initials: XB
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery; D001706:Biopsy; D002681:China; D049448:Cholangiopancreatography, Magnetic Resonance; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Biliary tract; Cystic tumor; Intraductal papillary mucinous neoplasm; Mucinous tumor; Papillary tumor