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01-09-2016 | Review Article

Treatment of branch-duct intraductal papillary mucinous neoplasms of the pancreas: state of the art

Authors: Stefano Crippa, Alessandra Piccioli, Maria Chiara Salandini, Chiara Cova, Francesca Aleotti, Massimo Falconi

Published in: Updates in Surgery | Issue 3/2016

Abstract

The diagnosis of branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) has been dramatically increased. BD-IPMNs are frequently discovered as incidental findings in asymptomatic individuals, mainly in elderly patients. An accurate evaluation of BD-IPMNs with high-resolution imaging techniques and endoscopic ultrasound is necessary. Patients with high-risk stigmata (HRS, obstructive jaundice, enhanced solid component) should undergo resection. Patients with worrisome features (WF, cyst size ≥3 cm, thickened enhanced cyst walls, non-enhanced mural nodules, and clinical acute pancreatitis) may undergo either a strict surveillance based on patients’ characteristics (age, comorbidities) or surgical resection. Non-operative management is indicated for BD-IPMNs without HRS and WF. Patients with BD-IPMN who do not undergo resection may develop malignant change over time as well as IPMN-distinct pancreatic cancer. However, non-operative management of BD-IPMNs lacking WF and HRS is safe and the risk of malignant degeneration seems relatively low. The optimal surveillance protocol is currently unclear.

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Title: Treatment of branch-duct intraductal papillary mucinous neoplasms of the pancreas: state of the art
Authors: Stefano Crippa
Alessandra Piccioli
Maria Chiara Salandini
Chiara Cova
Francesca Aleotti
Massimo Falconi
Publication date: 01-09-2016
Publisher: Springer Milan
Published in: Updates in Surgery / Issue 3/2016
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-016-0386-8

At a glance: The STEP trials

Springer Medicine

Treatment of branch-duct intraductal papillary mucinous neoplasms of the pancreas: state of the art

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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