| Theme | IPMN/Pancreatic Cyst as an Increasing Common Disease -- Current Status and Issues | |
|---|---|---|
| Title | Surgical Treatment for Intraductal Papillary Mucinous Neoplasm | |
| Publish Date | 2019/11 | |
| Author | Seiko Hirono | Second Department of Surgery, Wakayama Medical University, School of Medicine |
| Author | Hiroki Yamaue | Second Department of Surgery, Wakayama Medical University, School of Medicine |
| [ Summary ] | Once intraductal papillary mucinous neoplasm (IPMN) has invasive components, lymph node metastasis or postoperative extra‒pancreatic recurrence may occur, and then, the survival of invasive intraductal papillary mucinous carcinoma (IPMC) patients is worse than those with noninvasive IPMN. Therefore, we suggest that IPMN should be resected before the tumor progresses to invasive IPMC to prolong the survival for IPMN patients. Regarding operative procedures, regional lymph node dissection (as for pancreatic ductal adenocarcinoma) might be needed for invasive IPMC. Instead of total pancreatectomy, an operation with preserving pancreatic parenchyma should be considered to preserve long‒term endocrine and exocrine function if pathological the pancreatic cut margin does not have high‒grade dysplasia nor invasive IPMC. Regarding remnant pancreatic recurrence after surgical resection, remnant pancreatectomy for recurrence might prolong the survival for IPMN patients with remnant pancreatic recurrence. Long‒term surveillance might be necessary to evaluate the remnant pancreatic recurrence after surgical resection for IPMN. | |