2025 Volume 39 Issue 5 Pages 811-817
The patient is a man in his 70s. In 2002, he underwent extended right hepatic lobectomy and hilar cholangiectomy for Type 1 IPNB in the hilar region. Upon admission to our department in December 2011, a mass was detected in the left intrahepatic bile duct (B3). Five years passed without recurrence. Percutaneous transhepatic bile duct drainage was performed through the left intrahepatic bile duct (B3). A biopsy obtained via percutaneous transhepatic cholangioscopy (PTCS) from the mass at the stenosis revealed adenocarcinoma. The tumor was localized, and in February 2012, 10 years after the initial surgery, the patient underwent an extrahepatic sectional resection due to a multifocal occurrence following the initial surgery. The final pathological diagnosis was intraductal papillary neoplasm of the bile duct with high-grade intraepithelial neoplasia. This case did not recur until 12 years and 9 months after the reoperation, when the patient died of another disease. We report a rare case of re-resection of a multicentric lesion in the residual bile duct after radical surgery for IPNB, including its mechanism.
