Surgical management of intraductal papillary neoplasm of the biliary tract: single centre experience.

Intraductal papillary neoplasm of the bile duct (IPNB) is a rare premalignant biliary tumor characterized by papillary growth and mucin production with variable presentations and outcomes. Here, we discuss our early experience in managing this rare disease at a tertiary care centre. This observational retrospective study included patients with IPNB who underwent surgery from January 2020 to December 2025. Pre- and Peri-operative details were recorded, and outcomes were analysed. Ten cases were grouped into Intrahepatic mass forming (n = 3), Extrahepatic mass forming (n = 4), and Intrahepatic cystic IPNB (n = 3). Based on the location, formal anatomical liver resection was done for six patients (Right hepatectomy-3, central hepatectomy-2, and segmentectomy-1), en bloc extra-hepatic bile duct excision for two patients, and enucleation and pancreatoduodenectomy for one patient each. The median (IQR) operative time was 450 (180-600) minutes, and blood loss was 375 mL (200-1800 mL). The median hospital stay was 6 days (4-40). Two patients had Clavien Dindo Grade 3 or more complications with one perioperative mortality (1/10). The final histopathology was suggestive of IPNB with invasive carcinoma in four patients (40%). Among the nine patients who survived the perioperative period, all remained alive and free of disease after a median follow-up of 18 months (range, 8-47 months). Given the substantial risk of invasive carcinoma, complete surgical resection should be considered whenever feasible after appropriate staging. The intraoperative frozen section plays a crucial role in planning the extent of resection.