Intraductal Papillary Mucinous Tumor of the Pancreas (IPMT): Follow-Up of Twelve Cases

Abstract

Introduction: Intraductal papillary mucinous tumours (IPMT) were described as a distinct entity in I982. The extent of surgical resection for this disease remains controversial. Methods: Twelve patients with a diagnosis of IPMT were included in the present retrospective study. Results: Ten out of twelve patients had symptoms suggesting chronic pancreatitis. Two patients were not operated on due to biopsy-verified metastases in the liver. Nine patients were treated with a total pancreatectomy and one with a pancreaticoduodenectomy. In the ten patients operated on for IPMT, histological examination showed eight non-invasive- and two invasive carcinomas. In six cases, multifocal extensive intraductal changes were found, affecting either most of or the whole pancreas. There was no perioperative mortality. Six patients were alive at follow-up without recurrence and four patients were dead, two of them with recurrence. Conclusion: IPMTs represent a subgroup of pancreatic neoplasms with a favourable prognosis, and the resection should aim at removing all dysplastic foci. In cases with diffuse dilatation of the main pancreatic duct, widespread tumour involvement of the duct system can be expected and total pancreatectomy should be the operation of choice.