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ArticleSurgical case reports2026

Pancreaticobiliary Fistula Caused by Intraductal Papillary Mucinous Adenoma Requiring Pancreaticoduodenectomy.

Mina Nagao, Hironobu Suto, Hiroyuki Matsukawa, Junichi Fujiwara, Seiko Kagawa, Takuro Fuke, Yoshio Shimizu, Arata Nishigaki, Yasuhisa Ando, Minoru Oshima and 1 more

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Article in Surgical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Mina NagaoDepartment of Gastroenterological Surgery, Kagawa University, Kita, Kagawa, Japan.
Hironobu SutoDepartment of Gastroenterological Surgery, Kagawa University, Kita, Kagawa, Japan.
Hiroyuki MatsukawaDepartment of Gastroenterological Surgery, Kagawa University, Kita, Kagawa, Japan.
Junichi FujiwaraDepartment of Gastroenterological Surgery, Kagawa University, Kita, Kagawa, Japan.
Seiko KagawaDepartment of Diagnostic Pathology, Kagawa University, Kita, Kagawa, Japan.
Takuro FukeDepartment of Gastroenterological Surgery, Kagawa University, Kita, Kagawa, Japan.
Yoshio ShimizuDepartment of Gastroenterological Surgery, Kagawa University, Kita, Kagawa, Japan.
Arata NishigakiDepartment of Gastroenterological Surgery, Kagawa University, Kita, Kagawa, Japan.
Yasuhisa AndoDepartment of Gastroenterological Surgery, Kagawa University, Kita, Kagawa, Japan.
Minoru OshimaDepartment of Gastroenterological Surgery, Kagawa University, Kita, Kagawa, Japan.
Keiichi OkanoDepartment of Gastroenterological Surgery, Kagawa University, Kita, Kagawa, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFistula formation from the intraductal papillary mucinous neoplasm (IPMN) into neighboring organs is rare. We describe a case of pancreaticobiliary fistula with obstructive jaundice caused by an intraductal papillary mucinous adenoma (IPMA). CASE PRESENTATION: An 81-year-old man who was incidentally diagnosed with IPMN 11 years previously based on follow-up CT performed after nephrectomy for renal cell carcinoma. Gradual dilation of the main pancreatic duct was observed over time, confirming the high-risk stigmata for which surgery was recommended; however, the patient declined and was managed under surveillance. At a routine diabetes clinic visit, blood tests revealed inflammatory markers and hepatobiliary enzymes. Contrast-enhanced CT revealed a pancreatic head IPMN in extensive contact with the common bile duct with partial communication. Endoscopic nasobiliary drainage (ENBD) was performed, but resolution of jaundice proved difficult due to obstruction by mucin; therefore, we performed a subtotal stomach-preserving pancreaticoduodenectomy (SSPPD). Severe inflammation was observed around the pancreas and bile ducts at the surgical site. The postoperative course was favorable, and the patient was discharged on the POD 16. The histopathological diagnosis was intestinal-type IPMA.

conclusionsMost reported IPMN-related organ fistulas result from direct invasion by IPMC. By contrast, IPMA-related fistulation is exceedingly rare. We present an intestinal-type IPMA complicated by pancreaticobiliary fistula in which mucin defeated ENBD, necessitating SSPPD, and the patient had an uneventful recovery. This case shows that fistulation can occur even without IPMC and that early surgery should be considered in IPMN patients with pancreatobiliary fistula.

Indexed as

intraductal papillary mucinous neoplasmobstructive jaundicepancreaticobiliary fistulasurgery

Identifiers

PMID41913898
PMCPMC13033401

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