Intraductal papillary neoplasm of the bile duct (IPNB) is a rare disease in Western
countries. The main aim of this study was to characterize current surgical strategies
and outcomes in the mainly European participating centers.A multi-institutional retrospective
series of patients with a diagnosis of IPNB undergoing surgery between January 1,
2010, and December 31, 2020 was gathered under the auspices of the E-AHPBA. Textbook
outcome was defined as non-prolonged length of hospital stay plus absence of any Clavien-Dindo
grade ≥III complication, readmission, or mortality within 90 postoperative days.A
total of 28 centers contributed 85 patients who underwent surgery for IPNB. Median
age was 66 years (55-72), 49.4% were women and 87.1% Caucasian. Open surgery was performed
in 72 patients (84.7%), laparoscopic in 13 (15.3%). Textbook outcome was achieved
in 54.1% of patients, reaching 63.8% after liver resection, and 32.0% after pancreas
resection. Median overall survival was 5.72 years, with 5-year overall survival of
63% (95% CI 50-82). Overall survival was better in patients with Charlson comorbidity
score ≤4 versus >4 (P=0.016), intra- versus extra-hepatic tumor (P=0.027), single
versus multiple tumor (P=0.007), those who underwent hepatic versus pancreatic resection
(P=0.017), or achieved versus failed textbook outcome (P=0.029). Multivariable Cox
regression analysis showed that not achieving textbook outcome (HR 4.20, 95% CI 1.11-15.94,
P=0.03) was an independent prognostic factor of poor overall survival.Patients undergoing
liver resection for IPNB were more likely to achieve a textbook outcome than those
requiring a pancreatic resection. Comorbidity, tumor location and tumor multiplicity
influenced overall survival. Textbook outcome was an independent prognostic factor
of overall survival.
