کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3262656 1207740 2012 4 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Proper management and follow-up strategy of branch duct intraductal papillary mucinous neoplasms of the pancreas
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی غدد درون ریز، دیابت و متابولیسم
پیش نمایش صفحه اول مقاله
Proper management and follow-up strategy of branch duct intraductal papillary mucinous neoplasms of the pancreas
چکیده انگلیسی

Background and aimIt has been reported that main duct intraductal papillary mucinous neoplasms are more invasive and have a worse prognosis than branch duct intraductal papillary mucinous neoplasms. Therefore, an aggressive surgical approach has mainly been recommended for all MD-IPMNs. However, the surgical management of BD-IPMNs has been controversial and the consensus guidelines are not specific for an indicator of malignancy in BD-IPMNs. The objective of this study was to determine the proper management and follow-up strategy of BD-IPMNs.MethodsWe monitored and analysed patients with presumed BD-IPMNs between March 1995 and March 2010.ResultThe mean value of the initial cyst size in all patients with BD-IPMNs was 2.19 cm. Amongst 194 patients with BD-IPMNs, 34 underwent immediate surgical resection, 152 were followed conservatively. Amongst the 152 conservatively managed patients, 18 (11.8%) underwent surgical resection after a median follow-up of 12.7 months (range, 3–48 months). In 132 patients who were managed conservatively without surgery, the mean incremental rate of cyst size growth was 0.0038 cm/month during a median of 30.7 months of follow-up and there were no IPMN-related deaths.ConclusionAmongst patients with BD-IPMNs, about 10% have surgery within approximately 1 year from the time of diagnosis because of the occurrence of new malignant stigmata. Therefore, a conservative approach without surgery and careful follow-up every 3 months or 6 months during the first year after diagnosis can be safely advocated in patients with BD-IPMNs larger than 10 mm in size who have no risk factors for malignant IPMNs.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Digestive and Liver Disease - Volume 44, Issue 3, March 2012, Pages 257–260
نویسندگان
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