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Vusal Aliyev,Kentaro Yasuchika,Ahmed Hammad,Tetsuya Tajima,Ken Fukumitsu,Koichiro Hata,Hideaki Okajima,Shinji Uemoto 한국간담췌외과학회 2018 Annals of hepato-biliary-pancreatic surgery Vol.22 No.2
Intraductal papillary neoplasm of the bile duct (IPNB) is a rare variant of bile duct tumors characterized by papillary growth within the bile duct lumen and recognized precursor of invasive carcinoma. IPNB was detected incidentally in a 60-year-old woman during check up. Radiologic images revealed a huge cystic mass with papillary projection and markedly dilated bile ducts. Biopsies revealed high-grade IPNB. Cholangioscopy detected a connection between the right posterior bile duct and cyst lumen with epithelial dysplasia of the bile duct. Right posterior sectional duct opened in the left hepatic duct. Consequently, right trisectionectomy and extrahepatic bile duct resection were conducted. Histological studies revealed intraductal papillary neoplasm with high-grade intraepithelial neoplasia (carcinoma in situ). IPNB patients without distant metastases are candidates for surgery and complete resection should be conducted to achieve long-term survival.
Sclerosing encapsulating peritonitis after living-donor liver transplantation
Vusal Aliyev,Shintaro Yagi,Ahmed Hammad,Amr Badawy,Yudai Sasaki,Yuki Masano,Gen Yamamoto,Naoko Kamo,Kojiro Taura,Hideaki Okajima,Toshimi Kaido,Shinji Uemoto 한국간담췌외과학회 2018 Annals of hepato-biliary-pancreatic surgery Vol.22 No.2
Sclerosing encapsulating peritonitis (SEP), or abdominal cocoon is a rare cause of intestinal obstruction, and still etiology remains unknown. We report a series of 4 patients with abdominal cocoon, and all the 4 patients had previously undergone living-donor liver transplantation (LDLT). There was no evidence of SEP before and during LDLT. At the time of diagnosis of SEP, 3 out of 4 patients had ascites. First and fourth patients had multiple episodes or attacks of cholangitis, which were managed by percutaneous transhepatic biliary drainage and hepaticojejunostomy, respectively. All 4 patients presented with intestinal obstruction and 3 of them underwent a successful operation. The fourth patient died due to liver failure and complications of the SEP. The first 3 patients are doing well without SEP recurrence. Our experience suggest that the prognosis of SEP is poor in patients with poor graft liver functions after LDLT.