{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T03:15:50Z","timestamp":1777086950994,"version":"3.51.4"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"31","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:sec>\n            <jats:title>Rationale:<\/jats:title>\n            <jats:p>Intraductal papillary mucinous neoplasms (IPMNs) may perforate into adjacent organs, but pancreaticobiliary fistula caused by IPMN is rare. We present a rare case of pancreaticobiliary fistula due to a branch-duct IPMN, accelerated by a simultaneous ampullary carcinoma.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient concerns:<\/jats:title>\n            <jats:p>A woman in her 70s developed obstructive jaundice and cholangitis after a year of follow-up for IPMN.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Diagnoses:<\/jats:title>\n            <jats:p>Imaging revealed a branch-duct IPMN with a mural nodule and dilation of the main pancreatic duct, along with a dilated distal bile duct. Perforation into the bile duct and lymphadenopathy were observed. Histopathology later confirmed a high-grade intestinal-type IPMN and an incidental ampullary ductal carcinoma.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interventions:<\/jats:title>\n            <jats:p>The patient underwent endoscopic biliary drainage followed by pancreaticoduodenectomy after improvement of cholangitis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcomes:<\/jats:title>\n            <jats:p>The postoperative course was favorable. The pancreaticobiliary fistula was attributed to mechanical compression by mucin-producing IPMN, complicated by ampullary carcinoma.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Lessons:<\/jats:title>\n            <jats:p>This case highlights the importance of recognizing synergistic effects of concurrent periampullary neoplasms. Surgical resection may be curative and necessary to control complex biliary obstruction and infection.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/md.0000000000043563","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T23:01:42Z","timestamp":1754089302000},"page":"e43563","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Pancreaticobiliary fistula associated with intraductal papillary mucinous neoplasm and the simultaneous ampullary carcinoma: A case report"],"prefix":"10.1097","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2133-2787","authenticated-orcid":false,"given":"Yuki","family":"Itagaki","sequence":"first","affiliation":[{"name":"Department of Surgery, Teine Keijinkai Hospital, Sapporo, Japan"},{"name":"Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, 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