Biliary tract intraductal papillary mucinous neoplasm: Report of 19 cases

Table 1 Patient demographics (n = 19)

Feature	n (%)
Age (yr)
≤ 40	3 (15.8)
40-50	4 (21.1)
50-60	6 (31.6)
≥ 60	6 (31.6)
Sex
Male	11 (57.9)
Female	8 (42.1)

Table 2 Clinical features of biliary tract intraductal papillary mucinous neoplasm (n = 19)

Feature	n (%)
Presenting symptoms
Abdominal pain	15 (78.9)
Jaundice	7 (36.8)
Weight loss	3 (15.8)
None	1 (5.3)
Schistosomiasis1	4 (21.1)
Presence of cholangitis	16 (84.2)
Repeated episodes cholangitis	6 (31.6)
Location
Intrahepatic and hilum	13 (68.4)
Extrahepatic	5 (26.3)
Multifocal	1 (5.3)
Serum chemistry
Elevated CEA (> 3.4 ng/dL)	5 (26.3)
Elevated CA 19-9 (> 22 U/mL)	8 (42.1)

¹Detected by postoperative histologic examination. CA: Carbohydrate antigen; CEA: Carcinoembryonic antigen.

Table 3 Imaging features of biliary tract intraductal papillary mucinous neoplasm (n = 19)

Feature	n (%)
Biliary stones (n = 12)
Proximal	10 (52.6)
Proximal and distal	2 (10.5)
Cholecystolithiasis	0 (0.0)
Dilated bile duct (n = 19)
Proximal	6 (31.6)
Proximal and distal	13 (68.4)
Cyst	10 (52.6)
Lesion	10 (52.6)
Liver atrophy	7 (36.8)
Imaging examination
Ultrasonography	19 (100)
Computed tomography	15 (78.9)
Magnetic resonance imaging	12 (63.2)
Intraoperative choledochoscopy	8 (42.1)
Endoscopic retrograde cholangiography	4 (21.1)

Table 4 Operative strategies and outcomes for biliary tract intraductal papillary mucinous neoplasm (n = 19)

Feature	n (%)
Left hepatectomy (n = 11)
Lobectomy	6 (31.6)
Segmentectomy	5 (26.3)
Right hepatectomy (n = 2)
Segmentectomy	2 (10.5)
Pancreaticoduodenectomy	1 (5.3)
Bile duct excision	4 (21.1)
Biopsy and choledochojejunostomy	1 (5.3)
Complications (n = 4)
Stress ulcer	1 (5.3)
Intra-abdominal abscess	1 (5.3)
Pneumonia and bile leakage	1 (5.3)
Wound infection	1 (5.3)
Pathology
Benign	9 (47.4)
Malignant	10 (52.6)
Presence of mucin
Macroscopic visible mucin	19 (100)
Microscopic mucin	19 (100)
Lymph node metastasis	0 (0.0)
Death (n = 8)
Benign	3 (15.8)
Malignant	5 (26.3)