Background: intraductal papillary mucinous neoplasm
(IPMN) shows a series of lesions which evolve from benign lesions
–adenoma– to invasive carcinoma.
Aim: to analyze the clinical and pathological results of 15 patients
diagnosed of IPMN, and surgically treated according to the
guidelines of International Consensus Conference.
Material and methods: a retrospective analysis of 15 patients
surgically treated between March 1993 and September
2009, according to the International Consensus recommendation.
Demographic, diagnostic tools, surgical report, pathologic
database and actuarial survival were analyzed with a follow-up
from one and a half month through nine years.
Results: 6 patients underwent pancreaticoduodenectomies,
4 total pancreatectomies, 2 body or central pancreatectomies, 2 partial
pancreatectomies (enucleation) and 1 distal pancreatectomy.
A morbidity of 46 and 0% hospital mortality were assessed, with
a median length hospital stay of 10 days. In five cases, the IPMN
was combined type (both main and branch pancreatic ducts involved)
in four main duct-type and branch duct-type in the another
six as well. Several atypia (IPMN carcinoma in situ) was
observed in 2 patients and invasive carcinoma with negative
lymph nodes was identified in 3 patients. A patient without invasive
carcinoma died at 66 months of follow-up for pancreas adenocarcinoma.
The actuarial survival up to recurrence or death
was 105,133 months with a range of follow-up from 1 month
and a half until 9 years.
Conclusions: IPMN main duct or mixed type warrants complete
resection due to its incidence of invasive carcinoma or precursor
lesions of malignancy as well. Due to its multifocal pattern,
patients should be followed in long-term surveillance. The management
of asymptomatic IPMN type branch less than 3 cm is
controversial
