[en] [en] BACKGROUND: Intraductal papillary neoplasm of the bile ducts (IPNB) is a rare disease in Western countries. The aim of this study was to compare tumor characteristics, management strategies, and outcomes between Western and Eastern patients who underwent surgical resection for IPNB.
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.
Disciplines :
Surgery Gastroenterology & hepatology
Author, co-author :
Lluís, Núria ; Division of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, FL, USA. Electronic address: nurialluisv@gmail.com
Onoe, Shunsuke ; Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
Serradilla-Martín, Mario ; Instituto de Investigación Sanitaria Aragón, Department of Surgery, Miguel Servet University Hospital, Zaragoza, Spain. Electronic address: marioserradilla@hotmail.com
Achalandabaso, Mar ; HPB Surgery and Transplantation, Hospital Universitario Vall d'Hebron, Barcelona, Spain
Mizuno, Takashi ; Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
Jehaes, François; HPB Surgery & Liver Transplantation, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, University of Paris Cité, Clichy, France
Dasari, Bobby V M ; Liver Transplant and HPB Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom
Mambrilla-Herrero, Sara ; Hepatobiliary Surgery and Liver Transplant Unit, Cruces University Hospital, Bilbao, Spain
Sparrelid, Ernesto; Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Balakrishnan, Anita ; Cambridge HPB Unit, Cambridge University Hospitals NHS Foundation Trust, and Department of Surgery, University of Cambridge, Cambridge, UK
Hoogwater, Frederik J H; HPB Surgery and Liver Transplantation, and Pathology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
Amaral, María J ; General Surgery, Centro Hospitalar e Universitário de Coimbra, and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
Andersson, Bodil ; Department of Clinical Science Lund, Surgery, Lund University and Skane University Hospital, Lund, Sweden
Berrevoet, Frederik ; General and HPB Surgery, and Liver Transplantation, University Hospital Gent, Gent, Belgium
Doussot, Alexandre ; Department of Digestive Surgical Oncology, Liver Transplantation Unit, CHU Besançon, France
López-López, Víctor; General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
Detry, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie abdo, sénologique, endocrine et de transplantation
Pozo, Carlos Domingo-Del ; General and Digestive Surgery, Hospital Doctor Peset, Valencia, Spain
Machairas, Nikolaos ; Second Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Athens, Greece
Pekli, Damján; Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary
Alcázar-López, Cándido F ; HPB Surgery and Liver Transplantation, Dr. Balmis General University Hospital, and Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
Asbun, Horacio; Division of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, FL, USA
Björnsson, Bergthor ; Department of Surgery in Linköping and Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Christophides, Thalis; General Surgery Department, HPB Division, Nicosia General Hospital, Nicosia, Cyprus
Díez-Caballero, Alberto; Quirúrgica Cirujanos Asociados, Centro Médico Teknon, Barcelona, Spain
Francart, David; Department of Abdominal Surgery, CHC Groupe Santé, Liège, Belgium
Noel, Colin B ; HPB Clinical Unit, Gastrointestinal Surgery, Universitas Academic Hospital, University of the Free State, South Africa
Sousa-Silva, Donzília ; HEBIPA Surgery, Centro Hospitalar Universitário do Porto, Portugal
Toledo-Martínez, Enrique ; Hospital Universitario Marqués de Valdecilla, Santander, Spain
Tzimas, George N ; HPB Surgery, Department of Surgery, Hygeia Hospital, Athens, Greece
Yaqub, Sheraz ; HPB Surgery, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Yamaguchi, Junpei ; Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
Dokmak, Safi; HPB Surgery & Liver Transplantation, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, University of Paris Cité, Clichy, France
Prieto-Calvo, Mikel ; Hepatobiliary Surgery and Liver Transplant Unit, Cruces University Hospital, Bilbao, Spain
D'Souza, Melroy A ; Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Spiers, Harry V M ; Cambridge HPB Unit, Cambridge University Hospitals NHS Foundation Trust, and Department of Surgery, University of Cambridge, Cambridge, UK
van den Heuvel, Marius C ; HPB Surgery and Liver Transplantation, and Pathology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
Charco, Ramón ; HPB Surgery and Transplantation, Hospital Universitario Vall d'Hebron, Barcelona, Spain
Lesurtel, Mickaël ; HPB Surgery & Liver Transplantation, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, University of Paris Cité, Clichy, France
Ebata, Tomoki; Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
Ramia, José M ; HPB Surgery and Liver Transplantation, Dr. Balmis General University Hospital, and Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain, Miguel Hernández University, Alicante, Spain
