MANAGEMENT STRATEGIES FOR BRANCH DUCT INTRADUCTAL PAPILLARY-MUCINOUS NEOPLASMS

• Published in: Digestive endoscopy Vol. 18; no. s1; pp. S68 - S72
• Main Authors: Hanada, Keiji, Amano, Hajime, Hino, Fumiaki, Fukuda, Toshikatsu, Kuroda, Yoshinori
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.07.2006
• Subjects: branch duct type; intraductal papillary mucinous neoplasm; management strategy; prospective study
• ISSN: 0915-5635; 1443-1661
• DOI: 10.1111/j.1443-1661.2006.00625.x

Management strategies for branch duct intraductal papillary‐mucinous neoplasms (IPMN) have been discussed. The authors’ clinical criteria with special attention to the size of cystic lesion, the diameter of main pancreatic duct, and the size of mural nodule established in 2001 is useful for managing branch duct IPMN. A total of 55 of 60 cases with branch duct IPMN had no radiologic progression during an average follow up of 701 days. In addition, no case out of 27 cases with branch duct IPMN followed up for 3 years changed to positive in cytological examination using pancreatic juice. There were four cases of branch type IPMN with some changes in their image findings. There were two cases of branch type IPMN with pancreatic symptoms. A total of three out of these five cases were surgically resected. The ordinary‐type ductal carcinoma was detected in two cases with branch duct IPMN at 3 or 4 years later. These results suggest that a long‐term careful follow‐up study by computed tomography or ultrasonography at every 6 months would be needed in the management of branch duct IPMN. Further studies will be needed to dissolve this problem in the future.