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 language | English |
|---|---|
| Pages (from-to) | 1086-1090 |
| Number of pages | 5 |
| Journal | Gut |
| Volume | 56 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Aug 2007 |
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ASJC Scopus subject areas
- Gastroenterology
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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 journal › Article
}
TY - JOUR
T1 - Branch-duct intraductal papillary mucinous neoplasms of the pancreas
T2 - To operate or not to operate?
AU - Salvia, Roberto
AU - Crippa, Stefano
AU - Falconi, Massimo
AU - Bassi, Claudio
AU - Guarise, Alessandro
AU - Scarpa, Aldo
AU - Pederzoli, Paolo
PY - 2007/8
Y1 - 2007/8
N2 - 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
AB - 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
UR - http://www.scopus.com/inward/record.url?scp=34547227636&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34547227636&partnerID=8YFLogxK
U2 - 10.1136/gut.2006.100628
DO - 10.1136/gut.2006.100628
M3 - Article
C2 - 17127707
AN - SCOPUS:34547227636
VL - 56
SP - 1086
EP - 1090
JO - Gut
JF - Gut
SN - 0017-5749
IS - 8
ER -