Paramythiotis Daniel, Karlafti Eleni, Fotiadou Georgia, Charalampidou Maria, Karakatsanis Anestis, Ioannidis Aristeidis, Michalopoulos Antonios
First Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece.
Emergency Department, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54634 Thessaloniki, Greece.
Acta Med Litu. 2023;30(1):53-65. doi: 10.15388/Amed.2023.30.1.6. Epub 2023 Feb 27.
Intraductal papillary mucinous neoplasms (IPMNs) are the most frequent cystic pancreatic neoplasm. They derive from the main pancreatic duct or branch ducts.
This narrative review aims to present and compare the current guidelines on the management of IPMNs.
We reviewed the most important scientific literature on the management of IPMNs.
The clinical presentation of IPMNs is usually nonspecific; common symptoms are abdominal pain, weight loss, and jaundice. There are no sex differences, and the incidence increases with age. It is considered a premalignant lesion associated with synchronous or metachronous carcinomas. Multifocal sites within the pancreas and the presence of solid components, like mural nodules, are predictive factors for developing malignancy. Magnetic resonance imaging (MRI) is the imaging technique of choice. However, computed tomography (CT) and endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) can also contribute to the diagnosis. Resection is the optimal treatment for IPMNs that arise from the main duct, while several indications are suggested for the surgery on IPMNs of branch ducts.
The decision on surgery is not always a simple task and should be based on high-risk features of the neoplasm. In any case, re-examination and follow-up are highly recommended.
导管内乳头状黏液性肿瘤（IPMNs）是最常见的胰腺囊性肿瘤。它们起源于主胰管或分支胰管。
本叙述性综述旨在介绍和比较当前关于IPMNs管理的指南。
我们回顾了关于IPMNs管理的最重要的科学文献。
IPMNs的临床表现通常不具有特异性；常见症状为腹痛、体重减轻和黄疸。不存在性别差异，发病率随年龄增长而增加。它被认为是一种与同步或异时性癌相关的癌前病变。胰腺内的多灶性部位以及实性成分（如壁结节）的存在是发生恶性肿瘤的预测因素。磁共振成像（MRI）是首选的成像技术。然而，计算机断层扫描（CT）和内镜超声（EUS）结合细针穿刺活检（FNA）也有助于诊断。对于起源于主胰管的IPMNs，手术切除是最佳治疗方法，而对于分支胰管IPMNs的手术有几种指征。
手术决策并非总是一项简单的任务，应基于肿瘤的高危特征。无论如何，强烈建议进行复查和随访。
