Document Detail


Branch duct intraductal papillary mucinous neoplasms in a retrospective series of 190 patients.
MedLine Citation:
PMID:  19283746     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A consensus conference has recommended close observation of branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) smaller than 30 mm, without symptoms or mural nodules. This study investigated whether these recommendations could be validated in a single-centre experience of BD-IPMNs. METHODS: Some 190 patients with radiological imaging or histological findings consistent with BD-IPMN were enrolled between 1998 and 2005. Those with less than 6 months' follow-up and no histological confirmation were excluded. RESULTS: BD-IPMN was diagnosed by computed tomography and pancreatography in 105 patients and pathologically in 85. Eighteen patients had adenoma, 53 borderline malignancy, five carcinoma in situ and nine invasive carcinoma. Findings associated with malignancy were the presence of radiologically suspicious features (P < 0.001) and a cyst size of at least 30 mm (P = 0.001). Had consensus guidelines been applied, 54 patients would have undergone pancreatic resection, whereas only 28 of these patients actually had a resection; 12 of the latter patients had a malignancy compared with none of the 26 patients who were treated conservatively. CONCLUSION: A simple increase in cyst size is not a reliable predictor of malignancy. Observation is recommended for patients with a BD-IPMN smaller than 30 mm showing no suspicious features on imaging.
Authors:
S M Woo; J K Ryu; S H Lee; W J Yoon; Y-T Kim; Y B Yoon
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  The British journal of surgery     Volume:  96     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-18     Completed Date:  2009-03-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  405-11     Citation Subset:  AIM; IM    
Copyright Information:
(c) 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Yeongeon-dong, Jongno-gu, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma, Mucinous / diagnosis,  surgery*
Adult
Aged
Aged, 80 and over
Carcinoma, Pancreatic Ductal / diagnosis,  surgery*
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Pancreatic Neoplasms / diagnosis,  surgery*
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome

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