Surgical treatment of mucin-producing cholangiocarcinoma arising from intraductal papillary neoplasm of the intrahepatic bile duct: a report of 2 cases.
Intraductal papillary neoplasms of the bile duct (IPNB) leads to malignant transformation and mucin production. Herein, we presented two cases of mucin-producing IPNB with obstructive jaundice who underwent resection of the intrahepatic lesions and bypass hepaticojejunostomy. The first case was a 69 year-old male patient with 5-year follow up for gallstone disease. Imaging studies showed mucin-secreting IPNB mainly in the hepatic segment III bile duct (B3) and multiple intrahepatic duct stones for which, segment III resection, intrahepatic stone removal, end-to-side choledochojejunostomy and B3 hepaticojejunostomy were conducted. The second case was a 74 year-old female patient with 11-year follow up for gallstone disease. Imaging studies showed mucin-producing IPNB with dilatation of the segment IV duct (B4) and mural nodules for which, segment IV resection, partial resection of the diaphragm and central hepaticojejunostomy were conducted. Both patients recovered uneventfully from surgery. These cases highlight that in patients with IPNB, abundant production of highly viscous mucin inducing obstructive jaundice may be associated with malignant transformation.
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Department of General Surgery, Mongolian National University of Medical Science Hospital, Ulaanbaatar, Mongolia.
Namsrai
N
Baterdene
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Shin
S
Hwang
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Jong-Wook
JW
Lee
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Min-Jae
MJ
Jung
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Heeji
H
Shin
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hye Kyoung
HK
Seo
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Myeong-Hwan
MH
Kim
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Sung-Koo
SK
Lee
Intraductal growth; Intrahepatic cholangiocarcinoma; Jaundice; Mucin production; Papillary growth