Percutaneous transhepatic cholangioscopy-assisted biliary polypectomy for local palliative treatment of intraductal papillary neoplasm of the bile duct

Table 1 Histopathological and immunohistochemical findings in five patients with intraductal papillary neoplasm of the bile duct treated with percutaneous transhepatic cholangioscopy-assisted biliary polypectomy

Case No.	Histopathological findings	Subtype	Immunohistochemistry profiles
			Ki67	P53	MUC1	MUC2	MUC5AC	MUC6
11	IPNB with HGIN was diagnosed. 5 PTCS-BP sessions were performed. The tubular adenocarcinoma was identified in biopsies taken from the bile duct wall where the tumor was resected under PTCS 5 months later	IT	0.2	-	-	+	+	-
22	IPNB with mucinous adenocarcinoma was observed in resected specimens	IT	0.9	-	+	+	+	+
3	IPNB with LGIN was diagnosed with resected specimens	OT	0.1	-	-	-	+	-
42	IPNB with mucinous adenocarcinoma was identified in resected specimens under PTCS	PT	0.3	-	+	+	+	+
5	IPNB with HGIN was diagnosed in resected specimens. The patient developed intrahepatic bile duct-stomach fistula 32 months (August 2022) post- PTCS-BP due to drain obstruction induced by thick mucus	IT	0.7	-	-	+	+	-

¹Several specimens of percutaneous transhepatic cholangioscopy-assisted biliary polypectomy were associated with low-grade intraepithelial neoplasia (LGIN) and only a few were associated with high-grade intraepithelial neoplasia (HGIN).

²Intraductal papillary neoplasm of the bile duct (IPNB) with LGIN or HGIN was observed in several specimens, and IPNB with invasive carcinoma was observed in one resected specimen.

PTCS: Percutaneous transhepatic cholangioscopy; HGIN: High-grade intraepithelial neoplasia; LGIN: Low-grade intraepithelial neoplasia; IT: Intestinal type; OT: Oncocytic type; PT: Pancreatobiliary type.