Importance of main pancreatic duct dilatation in IPMN undergoing surveillance. BJS 2018; 105: 1825-1834.
Published: 14th August 2018
Authors: G. Marchegiani, S. Andrianello, G. Morbin, E. Secchettin, M. D'Onofrio, R. De Robertis et al.
The association between risk of pancreatic cancer and a dilated main pancreatic duct (MPD) in intraductal papillary mucinous neoplasm (IPMN) is debated. The aim of this study was to assess the role of MPD size in predicting pancreatic cancer in resected IPMNs and those kept under surveillance.
All patients with IPMN referred to the Pancreas Institute, University of Verona Hospital Trust, from 2006 to 2016 were included. The primary endpoint was the occurrence of malignancy detected at surgery or during follow‐up.
The final cohort consisted of 1688 patients with a median follow‐up of 60 months. Main pancreatic duct dilatation was associated with other features of malignancy in both the resected and surveillance groups. In patients who underwent resection, only a MPD of at least 10 mm was an independent predictor of malignancy. In patients kept under surveillance, MPD dilatation was not associated with malignancy. Fifteen of 71 patients (21 per cent) with malignancy in the resection cohort had a dilated MPD alone, whereas only one of 30 (3 per cent) under surveillance with MPD dilatation alone developed malignancy. Patients with a dilated MPD and other worrisome features had an increased 5‐year cumulative incidence of malignancy compared with those with a non‐dilated duct (11 versus 1·2 per cent; P < 0·001); however, the risk of malignancy was not significantly increased in patients with a dilated MPD alone (4 versus 1·2 per cent; P = 0·448).
In patients under surveillance, a dilated MPD alone was not associated with an increased incidence of malignancy in IPMN.Full text
You may also be interested in
Randomized clinical trial
Randomized trial of two types of gastrojejunostomy after pancreatoduodenectomy and risk of delayed gastric emptying (PAUDA trial).
Authors: J. Busquets, S. Martín, J. Fabregat, L. Secanella, N. Pelaez, E. Ramos et al.
Notes: No difference in outcomes
Effect of preoperative biliary drainage on cholestasis‐associated inflammatory and fibrotic gene signatures in perihilar cholangiocarcinoma.
Authors: M. J. Reiniers, L. de Haan, R. Weijer, J. K. Wiggers, A. Jongejan, P. D. Moerland et al.
Cost‐effectiveness of liver transplantation in patients with colorectal metastases confined to the liver.
Authors: G. M. W. Bjørnelv, S. Dueland, P.‐D. Line, P. Joranger, Å. A. Fretland, B. Edwin et al.
Notes: Not for every country
Mitochondrial function after associating liver partition and portal vein ligation for staged hepatectomy in an experimental model.
Authors: A. Budai, G. Horváth, L. Tretter, Z. Radák, E. Koltai, Z. Bori et al.
Notes: Defines the biochemical basis
Authors: M. Del Chiaro, K. Søreide
Multicentre study of the prognostic impact of preoperative bodyweight on long‐term prognosis of hepatocellular carcinoma.
Authors: J. J. Yu, F. Shen, T. H. Chen, L. Liang, J. Han, H. Xing et al.
Notes: BMI matters
Pancreas‐sparing, ampulla‐preserving duodenectomy for major duodenal (D1–D2) perforations. BJS 2018; 105: 1487-1492.
Authors: S. Di Saverio, E. Segalini, A. Birindelli, S. Todero, M. Podda, A. Rizzuto et al.
Notes: Useful option
Profile of exhaled‐breath volatile organic compounds to diagnose pancreatic cancer. BJS 2018; 105: 1493-1500.
Authors: S. R. Markar, B. Brodie, S.‐T. Chin, A. Romano, D. Spalding, G. B. Hanna et al.
Notes: Breath test for pancreatic cancer
Outcomes of pancreas retransplantation in patients with pancreas graft failure. BJS 2018; 105: 1816-1824.
Authors: S. Gasteiger, B. Cardini, G. Göbel, R. Oberhuber, F. Messner, T. Resch et al.
Notes: Good outcome in selected patients
Meta‐analysis of the prognostic role of perioperative platelet count in posthepatectomy liver failure and mortality. BJS 2018; 105: 1254-1261.
Authors: A. Mehrabi, M. Golriz, E. Khajeh, O. Ghamarnejad, P. Probst, H. Fonouni et al.
Notes: Low platelets, worse outcomes
Meta‐analysis of prognostic factors for overall survival in patients with resected hilar cholangiocarcinoma. BJS 2018; 105: 1408-1416.
Authors: N. T. E. Bird, A. McKenna, J. Dodd, G. Poston, R. Jones, H. Malik et al.
Notes: Tumour biology is important
Randomized clinical trial
Randomized clinical trial of stapler hepatectomy versus LigaSure™ transection in elective hepatic resection. BJS 2018; 105: 1119-1127.
Authors: J. Fritzmann, J. Kirchberg, D. Sturm, A. B. Ulrich, P. Knebel, A. Mehrabi et al.