Case Report
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Feb 21, 2010; 16(7): 909-913
Published online Feb 21, 2010. doi: 10.3748/wjg.v16.i7.909
Successful endoscopic procedures for intraductal papillary neoplasm of the bile duct: A case report
Kohei Tsuchida, Michiko Yamagata, Yasuyuki Saifuku, Dan Ichikawa, Kazunari Kanke, Toshimitsu Murohisa, Masaya Tamano, Makoto Iijima, Yukiko Nemoto, Wataru Shimoda, Toshiaki Komori, Hirokazu Fukui, Kazuhito Ichikawa, Hitoshi Sugaya, Kazuhito Miyachi, Takahiro Fujimori, Hideyuki Hiraishi
Kohei Tsuchida, Michiko Yamagata, Yasuyuki Saifuku, Dan Ichikawa, Kazunari Kanke, Toshimitsu Murohisa, Masaya Tamano, Makoto Iijima, Hitoshi Sugaya, Hideyuki Hiraishi, Department of Gastroenterology, Dokkyo Medical University, Tochigi 321-0293, Japan
Yukiko Nemoto, Wataru Shimoda, Toshiaki Komori, Kazuhito Miyachi, First Department of Surgery, Dokkyo Medical University, Tochigi 321-0293, Japan
Hirokazu Fukui, Kazuhito Ichikawa, Takahiro Fujimori, Department of Surgical and Molecular Pathology, Dokkyo Medical University, Tochigi 321-0293, Japan
Author contributions: Tsuchida K and Yamagata M designed the research and wrote the paper; Tsuchida K, Saifuku Y, Ichikawa D, Kanke K, Murohisa T, Tamano M, Iijima M, Nemoto Y, Shimoda W, Komori T and Miyachi K did the clinical work; Fukui H, Ichikawa K, Fujimori T analyzed the pathological data; Sugaya H and Hiraishi H reviewed the paper.
Correspondence to: Michiko Yamagata, MD, Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsugagun, Tochigi 321-0293, Japan. myamagat@dokkyomed.ac.jp
Telephone: +81-282-861111 Fax: +81-282-867761
Received: November 13, 2009
Revised: December 16, 2009
Accepted: December 23, 2009
Published online: February 21, 2010
Abstract

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.

Keywords: Biliary tract neoplasms; Papilloma; Endoscopic sphincterotomy; Endoscopic retrograde biliary drainage