Abstract
Intraductal papillary mucinous neoplasm of the bile duct (IPNB) is an epithelial tumor that can cause obstructive jaundice and cholangitis due to mucin production. Although the effectiveness of argon plasma coagulation in IPNB treatment has been demonstrated, the long-term effect of the therapy is largely unknown. Here, we have presented a patient with IPNB who underwent argon plasma coagulation with a follow-up period of more than 2 years. A 74-year-old woman was referred to our department for treatment of obstructive jaundice. Endoscopic retrograde cholangiopancreatography revealed marked dilation of intrahepatic and extrahepatic bile ducts and thick mucin drainage from the ampulla of Vater. IPNB was diagnosed pathologically from biopsy specimens. Surgery was not recommended because of the extensive intrahepatic spread of the lesion. Endoscopic sphincterotomy, endoscopic papillary large balloon dilation, and insertion of a metallic stent could not resolve the obstructive jaundice. Finally, argon plasma coagulation with percutaneous cholangioscopy was performed 3 times over 1 month. After treatment, obstructive jaundice was resolved and the patient’s clinical condition has been stable for more than 2 years, except for a single episode of transient cholangitis. In conclusion, argon plasma coagulation may be an alternative to surgery for the palliation of jaundice with IPNB.
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Change history
16 February 2021
A Correction to this paper has been published: https://doi.org/10.1007/s12328-020-01230-4
Abbreviations
- IPNB:
-
Intraductal papillary mucinous neoplasm of the bile duct
- APC:
-
Argon plasma coagulation
- RFA:
-
Radiofrequency ablation
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We would like to thank Editage (www.editage.com) for English language editing.
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Drafting of the paper: JA; critical revision of the manuscript: NT; revision of the manuscript: JK; and technical support: KK, CS, SK, KT, KK, MO, MS, and KT.
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For this article, formal consent was not required. However, we received informed consent about APC therapy from the patients after explaining the potential complications. The Ethics Committee of Mitsui Memorial Hospital approved this therapy, which conformed to the provisions of the Declaration of Helsinki (as revised in Fortaleza, Brazil, October 2013).
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Arai, J., Kato, J., Toda, N. et al. Long-term survival after palliative argon plasma coagulation for intraductal papillary mucinous neoplasm of the bile duct. Clin J Gastroenterol 14, 314–318 (2021). https://doi.org/10.1007/s12328-020-01199-0
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DOI: https://doi.org/10.1007/s12328-020-01199-0