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- W2894796124 abstract "Introduction: Papillary-type neoplasms of the bile ducts represent rare entities and sometimes-accurate diagnosis by common radiological and sampling methods is not satisfactory. The aim of this study is to report our experience in two patients with papillary biliary tumor, in which both surgical decision-making and optimal clinical outcome were achieved thanks to the contributions of choledoscopy and prompt radical liver resection procedures, respectively. Methods: Laboratory tests and imaging evaluations were pre-operatively achieved in both cases before to proceed with sampling tools. In the first case US-guided biopsy, endoscopic ultrasound-fine needle aspiration (EUS-FNA) and brush-cytology/intraductal aspiration (IDA) during endoscopic retrograde cholangiopancreatography(ERCP) were performed without conclusive results. In the second case, after a no-diagnostic EUS-FNA, a positron emission tomography revealed increased radiotracer uptake at the know lesion (maximal standardized uptake value equal to 4.6), suggesting a malignant process. Both patient underwent a choledoscopy that allowed to characterize histologically the lesions and consequently to plan surgery with radical left liver lobectomy, after positioning of a right PTBD. Results: Samples obtained through choledoscopy revealed high-grade dysplasia in both patients; in the second case the direct view offered by choledoscopy allowed the detection of papillary structures then confirmed by pathological report. Histological findings relative to surgical specimen revealed: intraductal papillary neoplasm of the biliary tree(IPNB) in the first case and invasive papillary adenocarcinoma in the second one, although well differentiated. Both patients are alive and well after 9 and 5 months, respectively. Conclusion: Choledoscopy allows a direct view of intraluminal biliary lesions and a specific oncologic targeting of liver resection plan." @default.
- W2894796124 created "2018-10-12" @default.
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- W2894796124 date "2018-09-01" @default.
- W2894796124 modified "2023-09-27" @default.
- W2894796124 title "Surgical management of the early-stage papillary-type neoplasm of the bile ducts" @default.
- W2894796124 doi "https://doi.org/10.1016/j.hpb.2018.06.1370" @default.
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