Proposal for a morphological classification of intraductal papillary neoplasm of the bile duct (IPN-B)

Hiroyuki Kato, Masami Tabata, Yoshinori Azumi, Ichiro Osawa, Masashi Kishiwada, Takashi Hamada, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai, Shuji Isaji

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: We propose a morphological classification of intraductal papillary neoplasm of the bile duct (IPN-B). Methods: A retrospective analysis of 16 patients with IPN-B who had undergone surgical resection was conducted. These 16 cases were classified into three types based on the primary lesion's anatomical location: branch duct type (6 cases), main duct type (5 cases) and mixed type (5 cases). In this paper we have analyzed the characteristics of IPN-B according to our new classification. Results: All branch duct type IPN-B was located in the left lobe and 5 of them were resected by left hepatectomy without extrahepatic bile duct resection (EBDR). On the other hand, all patients with main duct and mixed type IPN-B underwent EBDR in addition to hepatectomy or pancreatoduodenectomy. Microscopically, 2 of 6 patients with branch duct type IPN-B had no malignant component and, in the remaining 4 patients, cancer invasion was restricted to within the ductal wall. There were no cases of branch duct type IPN-B with lymph node metastasis and superficial intraductal tumor spread. In contrast, all patients with main duct and mixed duct type IPN-B had the malignant component. In all cases, lymph node metastasis was not observed, but superficial intraductal tumor spread was frequently found in extrahepatic bile duct lesions: 3 of main duct type and 3 of mixed type. Four patients with superficial intraductal spread had non-curative resection due to a cancer-positive ductal margin. Most patients with IPN-B obtained a good prognosis, but two patients with a cancer-positive ductal margin developed local recurrence. Conclusions: Our classification vividly reflects clinical and pathological characteristics of IPN-B and is useful to determine appropriate surgical strategy.

Original languageEnglish
Pages (from-to)165-172
Number of pages8
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume20
Issue number2
DOIs
Publication statusPublished - 01-02-2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Fingerprint Dive into the research topics of 'Proposal for a morphological classification of intraductal papillary neoplasm of the bile duct (IPN-B)'. Together they form a unique fingerprint.

  • Cite this