S1600 Intraductal Papillary Neoplasm of the Left Hepatic Duct Treated With Endoscopic Retrograde Cholangiopancreatography (ERCP)-Guided Radiofrequency Ablation

Background: Intraductal papillary neoplasm of the bile duct (IPNB) is a rare biliary benign tumor with atypical clinical features and is frequently misdiagnosed. Its treatment is limited and surgical resection is thought to be the only therapeutic option in patients with IPNB. With the aim of increasing the early diagnosis rate of IPNB and providing more therapeutic options for surgeons, we innovatively put forward the concept of combined utilization of SpyGlass and endoscopic endoluminal radiofrequency ablation (ERFA) in the diagnosis and treatment of IPNB.Case Presentation: An 85-year-old woman was referred to our hospital due to right upper quadrant abdominal pain. The image examinations indicated suspicious filling defects at the upper common bile duct. Further evaluation of SpyGlass cholangioscopy showed multiple reddish villous lesions at the left hepatic duct, and SpyBite biopsy under direct visualization demonstrated papillary low-grade dysplasia. In consideration of the advanced age and preference of the patient, the novel ERFA therapy was performed. The procedure was successful without periprocedural complications; the patient recovered uneventfully and was discharged 2 days after the operation. Upon follow-up, the patient was asymptomatic and in good physical condition at 8 months postoperatively.Conclusion: Preliminarily, we demonstrate that the strategy of a combination of SpyGlass and ERAF seems to be a promising, feasible, well-tolerated, and safe management for patients with IPNB. However, more data with larger patient volumes are needed to evaluate its outcomes further.

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Utility of Endoscopic Retrograde Cholangiopancreatography in the Treatment of Intraductal Papillary Neoplasm of the Bile Duct

ACG Case Reports Journal ◽

10.14309/crj.0000000000000122 ◽

2019 ◽

Vol 6 (7) ◽

pp. e00122

Author(s):

Nicolas Patel ◽

Adam Goodman

Keyword(s):

Bile Duct ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Endoscopic Retrograde ◽

Intraductal Papillary Neoplasm ◽

Papillary Neoplasm

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Evolving Role of Endoscopic Retrograde Cholangiopancreatography in Management of Extrahepatic Hepatic Ductal Injuries due to Blunt Trauma: Diagnostic and Treatment Algorithms

HPB Surgery ◽

10.1155/2008/259141 ◽

2008 ◽

Vol 2008 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Nikhil P. Jaik ◽

Brian A. Hoey ◽

S. Peter Stawicki

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

English Language ◽

Hepatic Duct ◽

Traumatic Injury ◽

Illustrative Case ◽

Endoscopic Retrograde ◽

Left Hepatic Duct ◽

Abdominal Ultrasonography ◽

Treatment Algorithms

Extrahepatic hepatic ductal injuries (EHDIs) due to blunt abdominal trauma are rare. Given the rarity of these injuries and the insidious onset of symptoms, EHDI are commonly missed during the initial trauma evaluation, making their diagnosis difficult and frequently delayed. Diagnostic modalities useful in the setting of EHDI include computed tomography (CT), abdominal ultrasonography (AUS), nuclear imaging (HIDA scan), and cholangiography. Traditional options in management of EHDI include primary ductal repair with or without a T-tube, biliary-enteric anastomosis, ductal ligation, stenting, and drainage. Simple drainage and biliary decompression is often the most appropriate treatment in unstable patients. More recently, endoscopic retrograde cholangiopancreatography (ERCP) allowed for diagnosis and potential treatment of these injuries via stenting and/or papillotomy. Our review of 53 cases of EHDI reported in the English-language literature has focused on the evolving role of ERCP in diagnosis and treatment of these injuries. Diagnostic and treatment algorithms incorporating ERCP have been designed to help systematize and simplify the management of EHDI. An illustrative case is reported of blunt traumatic injury involving both the extrahepatic portion of the left hepatic duct and its confluence with the right hepatic duct. This injury was successfully diagnosed and treated using ERCP.

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Robotic Repair of a Right Hepatic Artery-to-Common Hepatic Duct Fistula Status Post-Endoscopic Retrograde Cholangiopancreatography

Videoscopy ◽

10.1089/vor.2019.0632 ◽

2020 ◽

Vol 30 (2) ◽

Author(s):

Edwin Onkendi ◽

Adel Alhaj Saleh

Keyword(s):

Hepatic Artery ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Hepatic Duct ◽

Common Hepatic Duct ◽

Endoscopic Retrograde ◽

Right Hepatic Artery

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Primary Neuroendocrine Tumor of the Left Hepatic Duct: A Case Report with Review of the Literature

Case Reports in Surgery ◽

10.1155/2012/786432 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Ajay H. Bhandarwar ◽

Taher A. Shaikh ◽

Ashok D. Borisa ◽

Jaydeep H. Palep ◽

Arun S. Patil ◽

...

Keyword(s):

Standard Treatment ◽

Hepatic Duct ◽

Surgical Excision ◽

Diagnostic Tools ◽

Good Survival ◽

Review Of The Literature ◽

Endoscopic Retrograde ◽

Left Hepatic Duct ◽

Histopathologic Diagnosis ◽

Rare Malignancy

Primary Biliary Tract Neuroendocrine tumors (NET) are extremely rare tumors with only 77 cases been reported in the literature till now. We describe a case of a left hepatic duct NET and review the literature for this rare malignancy. To the best of our knowledge the present case is the first reported case of a left hepatic duct NET in the literature. In spite of availability of advanced diagnostic tools like Computerized Tomography (CT) Scan and Endoscopic Retrograde Cholangio Pancreaticography (ERCP) a definitive diagnosis of these tumors is possible only after an accurate histopathologic diagnosis of operative specimens with immunohistochemistry and electron microscopy. Though surgical excision remains the gold standard treatment for such tumors, patients with unresectable tumors have good survival with newer biologic agents like Octreotride.

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Villous adenoma of the common hepatic duct: the importance of contrast-enhanced ultrasound and endoscopic retrograde cholangiopancreatography for relevant diagnosis. A case report and review of the literature

Medical Ultrasonography ◽

10.11152/mu.2013.2066.174.vil ◽

2015 ◽

Vol 17 (4) ◽

Keyword(s):

Case Report ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Villous Adenoma ◽

Hepatic Duct ◽

Common Hepatic Duct ◽

Contrast Enhanced Ultrasound ◽

Review Of The Literature ◽

Endoscopic Retrograde ◽

Contrast Enhanced ◽

The Common

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A Case of Double Gallbladder with Adenocarcinoma Arising from the Left Hepatic Duct: A Case Report and Review of the Literature

Gastroenterology Research and Practice ◽

10.1155/2010/721946 ◽

2010 ◽

Vol 2010 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Masahiro Kawanishi ◽

Yukio Kuwada ◽

Yutaka Mitsuoka ◽

Shogo Sasao ◽

Teruo Mouri ◽

...

Keyword(s):

Congenital Anomaly ◽

Case Report ◽

Hepatic Duct ◽

Review Of The Literature ◽

Endoscopic Retrograde ◽

Left Hepatic Duct ◽

Rare Congenital Anomaly ◽

Open Laparotomy ◽

Double Gallbladder ◽

Biliary Anomaly

Double gallbladder is a rare congenital biliary anomaly, but an accessory gallbladder arising from the left hepatic duct is a more remarkably rare congenital anomaly. We report a case of double gallbladder with adenocarcinoma and gallstones, which was preoperatively diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) and then confirmed by open laparotomy. A review of the literature is presented.

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Management of Traumatic Liver and Bile Duct Laceration

Euroasian Journal of Hepato-Gastroenterology ◽

10.5005/jp-journals-10018-1247 ◽

2017 ◽

Vol 7 (2) ◽

pp. 188-190 ◽

Cited By ~ 2

Author(s):

Pankaj Dwivedi ◽

Mukta Waghmare ◽

Hemanshi Shah ◽

Charu Tiwari ◽

Kiran Khedkar

Keyword(s):

Bile Duct ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Blunt Abdominal Trauma ◽

Percutaneous Drainage ◽

Hepatic Duct ◽

Bile Leak ◽

Liver Trauma ◽

High Grade ◽

Hepatic Trauma ◽

Endoscopic Retrograde

ABSTRACT Posttraumatic major bile leak in children is uncommon, with few cases reported in the literature. These injuries are seen in high-grade liver trauma and are difficult to diagnose and manage. We describe a 7-year-old boy with grade IV hepatic trauma and bile leak following blunt abdominal trauma. The leak was successfully managed by percutaneous drainage and endoscopic retrograde cholangiopancreatography (ERCP) stenting of the injured hepatic duct. How to cite this article Tiwari C, Shah H, Waghmare M, Khedkar K, Dwivedi P. Management of Traumatic Liver and Bile Duct Laceration. Euroasian J Hepato-Gastroenterol 2017;7(2):188-190.

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Recurrent intraductal papillary neoplasm of the bile duct due to intraductal dissemination: a case report and literature review

Surgical Case Reports ◽

10.1186/s40792-021-01318-0 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yuki Nakayama ◽

Takahiro Tomino ◽

Mizuki Ninomiya ◽

Ryosuke Minagawa ◽

Yumi Oshiro ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Curative Resection ◽

Hepatic Duct ◽

Intraductal Papillary Neoplasm ◽

Gastric Type ◽

Papillary Structure ◽

The Common ◽

Papillary Neoplasm ◽

Papillary Growth

Abstract Background Intraductal papillary neoplasm of the bile duct (IPNB) is a subtype of biliary tumor. The 5-year survival rate of patients with IPNB who underwent curative resection is 81%. However, IPNB is known to often recur in other parts of the bile duct. Nevertheless, its mechanism remains poorly understood. Herein, we report the case of a patient with recurrent IPNB, which was considered to be attributed to intraductal dissemination in the common bile duct at 12 months after curative resection. We also made a review of the existing literature. Case presentation A 69-year-old man was referred to our hospital for the evaluation and dilation of an intrahepatic bile duct (IHBD) mass. Computed tomography (CT) findings confirmed a mass in the left hepatic duct. Left trisectionectomy, extrahepatic bile duct resection with biliary reconstruction, and regional lymph node dissection were performed. Intraoperative examination of the resection margin at the common bile duct and posterior segmental branch of the hepatic duct was negative for the presence of malignant cells. Histologically, the tumor showed intraductal papillary growth of the mucinous epithelium and was diagnosed as non-invasive IPNB. It had a papillary structure with atypical epithelial cells lined up along the neoplastic fibrovascular stalks. Immunohistochemically, this was as a gastric-type lesion. At 12 postoperative months, CT revealed a 1.5-cm mass in the lower remnant common bile duct. We performed subtotal stomach-preserving pancreaticoduodenectomy. The tumor exhibited papillary growth and was microscopically and immunohistochemically similar to the first tumor. At approximately 16 months after the patient’s second discharge, CT showed an abdominal mass at the superior mesenteric plexus, which was diagnosed as recurrent IPNB. Chemotherapy is ongoing, and the patient is still alive. In this case, as described in many previous reports, IPNB recurred below the primary lesion in the bile duct. Conclusion Based on our review of previous reports on IPNB recurrence, intraductal dissemination was considered one of the mechanisms underlying recurrence after multicentric development. Considering the high frequency and oncological conversion of recurrence in IPNB, regular follow-up examination is essential to achieve better prognosis in patients with recurrent IPNB.

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