Living donor liver transplantation for diffuse biliary papillomatosis with malignant change: A case report with 10-year follow-up

Jin Uk Choi; Shin Hwang; Dong-Hwan Jung; Gil-Chun Park; Chul-Soo Ahn; Ki-Hun Kim; Deok-Bog Moon; Tae-Yong Ha; Gi-Won Song; Sung-Gyu Lee

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자료유형: 학술저널

저자정보: Jin Uk Choi (University of Ulsan College of Medicine) Shin Hwang (University of Ulsan College of Medicine) Dong-Hwan Jung (University of Ulsan College of Medicine) Gil-Chun Park (University of Ulsan College of Medicine) Chul-Soo Ahn (University of Ulsan College of Medicine) Ki-Hun Kim (University of Ulsan College of Medicine) Deok-Bog Moon (University of Ulsan College of Medicine) Tae-Yong Ha (University of Ulsan College of Medicine) Gi-Won Song (University of Ulsan College of Medicine) Sung-Gyu Lee (University of Ulsan College of Medicine)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제24권 제2호

발행연도: 2020.5

수록면: 209 - 215 (7page)

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Biliary papillomatosis is a rare disease of the biliary tract. In this study, we present a case of a male patient with biliary papillomatosis with malignant change who underwent living donor liver transplantation (LDLT). The 49-year-old man was admitted due to intrahepatic ductal mass, which was finally diagnosed as biliary papillomatosis. It was initially treated by photodynamic therapy, but LDLT was planned due to low efficacy of photodynamic therapy. LDLT was performed with a right liver graft from his son. The pathology report revealed intraductal papillary neoplasm with associated invasive carcinoma. He recovered uneventfully. Although the distal bile duct resection margin was free of tumor, the risk of tumor recurrence at the remnant intrahepatic bile duct still remained. Therefore, staged pylorus-preserving pancreatoduodenectomy was planned. However, after 3 months, he was readmitted due to retropancreatic abscess. It took 6 months to control the intractable retropancreatic abscess. Due to late development of retropancreatic abscess and its slow recovery, staged pancreatoduodenectomy was no longer considered. The patient recovered complete at 1 year posttransplant without any evidence of disease recurrence. After 5 years posttransplant, lung metastasis developed and pulmonary metastasectomy was performed three times. No further recurrence developed during the last 3 years to date, and the patient currently is alive, 10 years after the LDLT. Experience on our case and literature review suggest that patients with biliary papillomatosis with or without malignant transformation are selectively indicated for liver transplantation.

#Biliary papillomatosis #Intraductal papillary neoplasm #Living donor liver transplantation #Lung metastasis

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