Intraductal papillary neoplasms of the bile ducts: a comparative study of a rare disease in Europe and Nagoya, Japan.
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Lluís Núria, Onoe Shunsuke, Serradilla-Martín Mario, Achalandabaso Mar, Mizuno Takashi, Jehaes François, Dasari Bobby V M, Mambrilla-Herrero Sara, Sparrelid Ernesto, Balakrishnan Anita, Hoogwater Frederik J H, Amaral María J, Andersson Bodil, Berrevoet Frederik, Doussot Alexandre, López-López Víctor, Detry Olivier, Pozo Carlos Domingo-Del, Machairas Nikolaos, Pekli Damján, Alcázar-López Cándido F, Asbun Horacio, Björnsson Bergthor, Christophides Thalis, Díez-Caballero Alberto, Francart David, Noel Colin B, Sousa-Silva Donzília, Toledo-Martínez Enrique, Tzimas George N, Yaqub Sheraz, Yamaguchi Junpei, Dokmak Safi, Prieto-Calvo Mikel, D'Souza Melroy A, Spiers Harry V M, van den Heuvel Marius C, Charco Ramón, Lesurtel Mickaël, Ebata Tomoki, Ramia José M
Аннотация
METHODS: A multi-institutional retrospective series of patients with IPNB undergoing surgery between January 2010 and December 2020 was gathered under the auspices of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), and at Nagoya University Hospital, Japan.
RESULTS: A total of 85 patients (51% male; median age 66 years) from 28 E-AHPBA centers were compared to 91 patients (64% male; median age 71 years) from Nagoya. Patients in Europe had more multiple lesions (23% vs 2%, P < .001), less invasive carcinoma (42% vs 85%, P < .001), and more intrahepatic tumors (52% vs 24%, P < .001) than in Nagoya. Patients in Europe experienced less 90-day grade >3 Clavien-Dindo complications (33% vs 68%, P < .001), but higher 90-day mortality rate (7.0% vs 0%, P = .03). R0 resections (81% vs 82%) were similar. Overall survival, excluding 90-day postoperative deaths, was similar in both regions.
DISCUSSION: Despite performing more extensive resections, the low perioperative mortality rate observed in Nagoya was probably influenced by a combination of patient-, tumor-, and surgery-related factors.