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Long-term survival after palliative argon plasma coagulation for intraductal papillary mucinous neoplasm of the bile duct

A Correction to this article was published on 19 September 2020

This article has been updated

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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Fig. 1
Fig. 2

Change history

Abbreviations

IPNB:

Intraductal papillary mucinous neoplasm of the bile duct

APC:

Argon plasma coagulation

RFA:

Radiofrequency ablation

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

This research received no specific grants from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors

Contributions

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.

Corresponding author

Correspondence to Nobuo Toda.

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The authors declare that they have no conflicts of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

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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Keywords

  • Intraductal papillary mucinous neoplasm of the bile duct
  • Cholangioscopy
  • Argon plasma coagulation