| Theme |
The Current State of Management of Intraductal Papillary Mucinous Neoplasm (IPMN) of the Pancreas |
| Title |
Natural Course of Main duct IPMN of the Pancreas |
| Author |
Hiroyuki Uehara |
Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author |
Takeshi Tamura |
Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author |
Hironari Sueyoshi |
Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author |
Ryoji Takada |
Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author |
Nobuyasu Fukutake |
Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author |
Kazuyoshi Ohkawa |
Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| [ Summary ] |
Surgery is recommended for all main duct intraductal papillary mucinous neoplasms (IPMNs) of the pancreas because of their high frequency of malignancy. However, the outcomes of follow-up of main duct IPMNs that were not surgically resected revealed that not all neoplasms progressed, and some remained unchanged during the natural course of the neoplasm. The International Consensus Guidelines for the management of IPMN of the pancreas updated in 2012 changed the definition of main-duct IPMNs : that is, the threshold of the main pancreatic duct (MPD) dilatation was reduced from 10 mm to 5 mm. These guidelines recommend surgical resection of all main-duct IPMNs with MPD dilatation of ≥ 10 mm but recommend surveillance without immediate resection for neoplasms with MPD dilatation of 5-9 mm ; however, this indication has not yet been validated. Criteria for surgery for main duct IPMNs should be established. |