Intraductal papillary neoplasm of the bile ducts (IPNB) is a rare disease in Western
countries. The aim of this study was to compare tumor characteristics, management
strategies, and outcomes between Western and Eastern patients who underwent surgical
resection for IPNB.A multi-institutional retrospective series of patients with IPNB
undergoing surgery between January 2010 and December 2020 was gathered under the auspices
of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), and at Nagoya
University Hospital, Japan.A total of 85 patients (51% male; median age 66 years)
from 28 E-AHPBA centers were compared to 91 patients (64% male; median age 71 years)
from Nagoya. Patients in Europe had more multiple lesions (23% vs 2%, P < .001), less
invasive carcinoma (42% vs 85%, P < .001), and more intrahepatic tumors (52% vs 24%,
P < .001) than in Nagoya. Patients in Europe experienced less 90-day grade >3 Clavien-Dindo
complications (33% vs 68%, P < .001), but higher 90-day mortality rate (7.0% vs 0%,
P = .03). R0 resections (81% vs 82%) were similar. Overall survival, excluding 90-day
postoperative deaths, was similar in both regions.Despite performing more extensive
resections, the low perioperative mortality rate observed in Nagoya was probably influenced
by a combination of patient-, tumor-, and surgery-related factors.
