The Clinicopathological Characteristics And Prognosis Of Biliary Intraductal Papillary Neoplasm

Purpose:Biliary intraductal papillary neoplasm is a very uncommon disease,that is characterized by variously papillary adenomas in both the intrahepatic and extrahepatic or the whole biliary tract that may be occurred either a sector or isolated or disseminated or involved the entire biliary tree.Because of Biliary intraductal papillary neoplasm is a rare,the pathogenesis,clinical course,histopathological characteristics are largely unclear,preoperative diagnosis is really difficult and very easily misdiagnosed.Therefore,copulative medical case,treat of biliary intraductal papillary neoplasm's clinical manifestation,radiological feature and histopathological characteristics,further to analyze biliary intraductal papillary neoplasm viability clinical treatment method and its prognosis.Methods:a retrospective analysis was diagnosed of 24 patients who underwent surgery and verified by pathological,to review and analyze and evaluate its clinical manifestation,radiological feature and histopathological characteristics,and its prognosis.Results:Its commonly see clinical manifestation:Repeated episodes of fever and epigastric pain with or without jaundice;progressive cumulative jaundice without fever and epigastric pain.Radiological(B ??CT?MR)inspection result:diffuse or limitation bile duct dilatation with cystic change in intrahepatic or extrahepatic,without finding any obvious tumor or large calculus.Endoscopic retrograde cholangiopancreatography finded an amorphous filling defect in bile duct and taken out tremelloid material from biliopancreatic duct and common bile duct..Surgical treatment(right hemihepatectomy operation,left hemihepatectomy operation,local excision,local excision and bilioenteric anastomosis),in dilation bile duct,the cancer specimen showed mamillary predominantly,also showed nodositas,moreover was mucin-producing.The two patients healed and no lnnai death.Upon follow-up,no signs of recurrence or tumor metastasis(median 14±8 months).Conclusions:Biliary intraductal papillary neoplasm is a rare mucin-producing papillary or villous tumorsof the mucosa of the biliary tree.Combined the histopathological features with biological behavior,its should be considered a premalignant disease with high malignant potential.Radical surgery and tumor marginal completeness removal are regarded only effectual treatment method.In case,the tumor is incapable of completeness removal,liver transplantation and photodynamic therapy also are regarded a sort of treatment method.