Uhl W, Belyaev O, Herzog T, Mueller C A, Seelig M, Schmidt W, Hohenberger W, Ellenrieder V
Chirurgische Klinik, St.-Josef-Hospital, Ruhr-Universität Bochum, Bochum.
Z Gastroenterol. 2008 Nov;46(11):1290-7. doi: 10.1055/s-2008-1027823. Epub 2008 Nov 14.
Intraductal papillary mucinous neoplasms (IPMN) are the most common cystic tumours of the pancreas. The preoperative diagnosis of IPMN malignancy is difficult and the majority of IPMN are malignant upon diagnosis. Thus, only the early radical resection of the pancreas with regional lymph node dissection offers the patient a chance for cure. A discussion of the type "to resect or not to resect" should, furthermore, be held only within the walls of high-volume pancreatic centres and patients managed by the "watchful waiting" strategy (mainly branch-duct type IPMN) should all be recruited into large randomised controlled trials aimed to discover reliable diagnostic criteria to differentiate between invasive and non-invasive IPMN. Until then an aggressive surgical approach should be recommended as the standard treatment for all patients with IPMN.
导管内乳头状黏液性肿瘤（IPMN）是胰腺最常见的囊性肿瘤。IPMN恶性肿瘤的术前诊断困难，且大多数IPMN在诊断时即为恶性。因此，只有早期行胰腺根治性切除并进行区域淋巴结清扫，才为患者提供治愈机会。此外，关于“是否切除”的讨论应仅在大型胰腺中心内部进行，并且所有采用“密切观察等待”策略（主要是分支导管型IPMN）治疗的患者都应纳入大型随机对照试验，旨在发现区分侵袭性和非侵袭性IPMN的可靠诊断标准。在此之前，应推荐积极的手术方法作为所有IPMN患者的标准治疗。
