Treatment of branch duct type intraductal papillary-mucinous neoplasms of the pancreas. A physician's viewpoint

DOI 5 Citations 36 References
  • ARITA Yoshiyuki
    Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University
  • ITO Tetsuhide
    Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University

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  • ＩＰＭＮの治療方針　　分枝型ＩＰＭＮの治療方針―内科の立場から

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Abstract

Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas can be divided into two distinct clinical subtypes ; main duct type and branch duct type. Each subtype of IPMNs should be treated adequately because the branch type IPMN has less malignant potential than the main duct type. Preoperative differentiation between malignant and benign branch type IPMNs requires conventional imaging studies, which allow prediction of malignancy based on tumor diameter, mural nodules and main pancreatic duct diameter, as well as cytological examination of the pancreatic juice. Prognostic factors of branch type IPMN include malignant potential of IPMNs, concomitant pancreatic ductal carcinomas, extrapancreatic malignancies, recurrent IPMNs of the residual pancreas, development of diabetes and underlying diseases. The proposed International Consensus Guideline for Management of IPMN and MCN of the pancreas (Tanaka M, et al. Pancreatology 2006 ; 6 : 17-32.) should standardize the treatment of IPMNs in the near future. Any treatment strategy for branch type IPMNs should take into consideration the general condition of the patient, prognosis of underlying diseases, possible concomitant pancreatic or extrapancreatic carcinoma, and endocrine/exocrine pancreatic function, in addition to the status of the pancreas.

Journal

  • Suizo

    Suizo 20 (6), 501-510, 2005

    Japan Pancreas Society

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