| Theme | IPMT ; Intraductal Papillary-Mucinous Tumor | |
|---|---|---|
| Title | Intraductal Papillary-Mucinous Tumor-Surgical Treatment | |
| Publish Date | 2006/02 | |
| Author | Koji Yamaguchi | Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author | Masato Watanabe | Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author | Hiroyuki Konomi | Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author | Masafumi Nakamura | Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author | Masao Tanaka | Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| [ Summary ] | Intraductal papillary-mucinous tumor is a disease ranging from hyperplasia, adenoma, non-invasive carcinoma, and minimally invasive carcinoma to invasive ductal carcinoma derived from IPMT. Macroscopic differentiation of the main pancreatic duct (+ mixed) type and the branch duct type is important to decide on surgical strategies ; The main pancreatic duct (+ mixed) type is an indication for surgical resection because IPMT of the main pancreatic duct is frequently malignant, while IPMT of the branch duct is an indication for surgery, depending on the size of the lesion (≥3 cm), the presence of mural nodules (≥6 mm) and / or dilated main pancreatic ducts (≥6 mm). When the preoperative diagnosis is non-invasive carcinoma or conditions less serious than non-invasive carcinoma, various types of limited pancreatic resection are the treatments of choice. When the preoperative diagnosis is minimally invasive carcinoma, pancreatic resection with D 2 lymph node dissection is indicated. In IPMT, neoplastic cells characteristically spread intraductally and examination of the surgical margins is important, including intraoperative frozen section diagnosis. The postoperative clinical course is influenced by the grade of malignancy, as determined by histological examination of resected specimens. Pancreatic cancer or malignant conditions of the other organs frequently accompany IPMT. Malignant diseases accompanying IPMT should be carefully checked for preoperatively and postoperatively in patients with IPMT. | |