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World J Gastroenterol. Oct 14, 2023; 29(38): 5361-5373
Published online Oct 14, 2023. doi: 10.3748/wjg.v29.i38.5361
Intraductal papillary neoplasm of the bile duct: The new frontier of biliary pathology
Federico Mocchegiani, Paolo Vincenzi, Grazia Conte, Daniele Nicolini, Roberta Rossi, Andrea Benedetti Cacciaguerra, Marco Vivarelli
Federico Mocchegiani, Andrea Benedetti Cacciaguerra, Marco Vivarelli, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona 60126, Italy
Paolo Vincenzi, Grazia Conte, Daniele Nicolini, Roberta Rossi, Department of Gastroenterology and Transplant, United Hospital of Marche, Ancona 60126, Italy
Author contributions: Mocchegiani F and Vincenzi P wrote and revised the paper; Benedetti Cacciaguerra A and Rossi R performed the research; Conte G and Nicolini D analyzed the data; Vivarelli M revised the paper.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Federico Mocchegiani, MD, Associate Professor, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Via Tronto 10 a, Ancona 60126, Italy. federico.mocchegiani@ospedaliriuniti.marche.it
Received: May 31, 2023
Peer-review started: May 31, 2023
First decision: July 23, 2023
Revised: August 7, 2023
Accepted: August 31, 2023
Article in press: August 31, 2023
Published online: October 14, 2023
Core Tip

Core Tip: Intraductal papillary neoplasms of the bile duct are rare premalignant lesions, which are especially prevalent in East Asia. Due to the lack of specific guidelines addressing their management, recent subclassification of types 1 and 2 clarifies several aspects, particularly histopathological, clinical and prognostic features. Magnetic resonance imaging and cholangioscopy occupy a central role in diagnosis and treatment. Surgery is the most appropriate treatment, yielding optimal results in terms of survival, although endoscopic techniques have been used, particularly in nonsurgically fit patients. Lastly, recent genetic research has focused on identifying targeted therapies acting on the stepwise progression of neoplastic biliary epithelium.