HPB : the official journal of the International Hepato Pancreato Biliary Association · 2025
Intraductal papillary neoplasm of the bile duct.
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Aziz Hassan, Seda Peyton, Gosse Matthew, Aswani Yashant, Pawlik Timothy M
Аннотация
BACKGROUND: Intraductal papillary neoplasm of the bile duct (IPNB) was formally adopted in the 2010 WHO classification as a distinct clinical and pathological entity. We herein review the concept, clinical and pathologic features, as well as the prognosis of IPNB.
METHODS: A comprehensive review was conducted using MEDLINE/PubMed, Google Scholar, Cochrane Library, and the Web of Science, which were accessed between 2004 and 2025. The main search focused on "Intraductal papillary neoplasm of the bile duct."
RESULTS: IPNB often present with intermittent right upper quadrant abdominal pain, recurrent episodes of acute cholangitis, obstructive jaundice with macroscopic or microscopic mucin, and dilation of the proximal bile duct. On histology, IPNB is characterized by papillary proliferation of neoplastic biliary epithelial cells with delicate fibrovascular stalks within the bile duct. MRI, including MRCP, has the highest diagnostic sensitivity (65.5 %) followed by CT (50 %). Surgical resection with a negative margin is the treatment of choice. In contrast to flat intraductal neoplasia-associated cholangiocarcinoma, IPNB has a better prognosis and postoperative outcome with a 5-year survival of 70-81 % although risk of recurrence can be high.
CONCLUSION: Clinicians need to be familiar with the presentation, diagnosis, and treatment of IPNB lesions.
METHODS: A comprehensive review was conducted using MEDLINE/PubMed, Google Scholar, Cochrane Library, and the Web of Science, which were accessed between 2004 and 2025. The main search focused on "Intraductal papillary neoplasm of the bile duct."
RESULTS: IPNB often present with intermittent right upper quadrant abdominal pain, recurrent episodes of acute cholangitis, obstructive jaundice with macroscopic or microscopic mucin, and dilation of the proximal bile duct. On histology, IPNB is characterized by papillary proliferation of neoplastic biliary epithelial cells with delicate fibrovascular stalks within the bile duct. MRI, including MRCP, has the highest diagnostic sensitivity (65.5 %) followed by CT (50 %). Surgical resection with a negative margin is the treatment of choice. In contrast to flat intraductal neoplasia-associated cholangiocarcinoma, IPNB has a better prognosis and postoperative outcome with a 5-year survival of 70-81 % although risk of recurrence can be high.
CONCLUSION: Clinicians need to be familiar with the presentation, diagnosis, and treatment of IPNB lesions.