Wu Xin, Li Binglu, Zheng Chaoji, Chang Xiaoyan, Zhang Taiping, He Xiaodong, Zhao Yupei
1 Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
2 Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Int Med Res. 2018 Oct;46(10):4258-4268. doi: 10.1177/0300060518792800. Epub 2018 Aug 15.
Objective Intraductal papillary neoplasm of the bile duct (IPNB) has been increasingly recognized and reported. However, its clinical features are still controversial because of its low incidence. In the present study, we investigated the characteristics of IPNB. Methods In total, 28 patients with IPNB were treated at our institution from January 2000 to December 2016. Clinical data were collected and a retrospective accurate database was constructed. Demographic characteristics, perioperative management, and prognosis were retrospectively analyzed. Results Abdominal discomfort was the most common symptom. Preoperative imaging revealed biliary tract dilatation in 23 patients. Left lateral or left hepatic lobectomy was the most frequently performed surgical procedure. Histological analysis revealed malignancy in 17 patients. Eighty-eight lymph nodes were swept from the patients with malignant disease, but only three were metastatic. Twenty-one patients were followed up for 3 to 60 months (mean, 29.4 ± 18.2 months). Seven patients died during the follow-up period. Patients with benign tumors had significantly greater disease-free survival. Conclusions IPNB is a rare biliary disease that occurs mainly in patients of advanced age. The most common symptom is abdominal discomfort. Lymphatic metastasis is uncommon. Patients with benign tumors may have a better prognosis than those with malignant tumors.
目的 胆管内乳头状瘤（IPNB）已得到越来越多的认识和报道。然而，由于其发病率低，其临床特征仍存在争议。在本研究中，我们调查了IPNB的特征。方法 2000年1月至2016年12月期间，共有28例IPNB患者在我院接受治疗。收集临床资料并建立回顾性精确数据库。对人口统计学特征、围手术期管理和预后进行回顾性分析。结果 腹部不适是最常见的症状。术前影像学检查显示23例患者存在胆道扩张。左外侧或左肝叶切除术是最常施行的手术方式。组织学分析显示17例患者为恶性。对患有恶性疾病的患者清扫了88个淋巴结，但仅有3个发生转移。21例患者接受了3至60个月的随访（平均29.4±18.2个月）。7例患者在随访期间死亡。良性肿瘤患者的无病生存期明显更长。结论 IPNB是一种罕见的胆道疾病，主要发生于老年患者。最常见的症状是腹部不适。淋巴转移不常见。良性肿瘤患者的预后可能优于恶性肿瘤患者。
