Branch-duct intraductal papillary mucinous neoplasms of the pancreas: To operate or not to operate?

Roberto Salvia, Stefano Crippa, Massimo Falconi, Claudio Bassi, Alessandro Guarise, Aldo Scarpa, Paolo Pederzoli

Research output: Contribution to journalArticle

223 Citations (Scopus)

Abstract

Background: Branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) of the pancreas are reported to be less aggressive than the main-duct type. Hence, less aggressive treatment has been proposed for the former. Aim: To evaluate the effectiveness of a follow-up protocol for BD-IPMNs. Design: Prospective study. Setting: An academic tertiary referral centre. Patients: From 2000 to 2003, 109 patients with BD-IPMNs underwent trans-abdominal ultrasound and magnetic resonance cholangiopancreatography with secretin. Patients who presented malignancy-related parameters (size >3.5 cm, nodules, thick walls, carbohydrate antigen 19.9 level >25 U/l, recent-onset or worsened diabetes) and/or complained of symptoms were submitted to surgery (arm A). All asymptomatic patients without suspicion of malignancy were followed up according to a 6-month clinical-radiological protocol (arm B). Main outcome measures: The effectiveness of conservative management of BD-IPMNs. Results: 20 (18.3%) patients underwent surgery (arm A); pathological diagnosis of BD-IPMNs was always confirmed. 89 (81.7%) patients were followed up for a median of 32 months (arm B); of these, 57 (64%) patients had multifocal disease. After a mean follow-up of 18.2 months, 5 (5.6%) patients showed an increase in lesion size and underwent surgery. The pathological diagnosis was branch-duct adenoma in three patients and borderline adenoma in two. Conclusions: Surgery is indicated in

Original languageEnglish
Pages (from-to)1086-1090
Number of pages5
JournalGut
Volume56
Issue number8
DOIs
Publication statusPublished - Aug 2007

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Pancreatic Neoplasms
Neoplasms
Adenoma
Magnetic Resonance Cholangiopancreatography
Secretin
Clinical Protocols
Tertiary Care Centers
Carbohydrates
Outcome Assessment (Health Care)
Prospective Studies
Antigens

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Salvia, R., Crippa, S., Falconi, M., Bassi, C., Guarise, A., Scarpa, A., & Pederzoli, P. (2007). Branch-duct intraductal papillary mucinous neoplasms of the pancreas: To operate or not to operate? Gut, 56(8), 1086-1090. https://doi.org/10.1136/gut.2006.100628

Branch-duct intraductal papillary mucinous neoplasms of the pancreas : To operate or not to operate? / Salvia, Roberto; Crippa, Stefano; Falconi, Massimo; Bassi, Claudio; Guarise, Alessandro; Scarpa, Aldo; Pederzoli, Paolo.

In: Gut, Vol. 56, No. 8, 08.2007, p. 1086-1090.

Research output: Contribution to journalArticle

Salvia, R, Crippa, S, Falconi, M, Bassi, C, Guarise, A, Scarpa, A & Pederzoli, P 2007, 'Branch-duct intraductal papillary mucinous neoplasms of the pancreas: To operate or not to operate?', Gut, vol. 56, no. 8, pp. 1086-1090. https://doi.org/10.1136/gut.2006.100628
Salvia, Roberto ; Crippa, Stefano ; Falconi, Massimo ; Bassi, Claudio ; Guarise, Alessandro ; Scarpa, Aldo ; Pederzoli, Paolo. / Branch-duct intraductal papillary mucinous neoplasms of the pancreas : To operate or not to operate?. In: Gut. 2007 ; Vol. 56, No. 8. pp. 1086-1090.
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