de Pretis Nicolò, Martinelli Luigi, Amodio Antonio, Caldart Federico, Crucillà Salvatore, Battan Maria Sole, Zorzi Alberto, Crinò Stefano Francesco, Conti Bellocchi Maria Cristina, Bernardoni Laura, De Marchi Giulia, Campagnola Pietro, Salvia Roberto, Gabbrielli Armando, Marcon Alessandro, Frulloni Luca
Gastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy.
Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy.
Diagnostics (Basel). 2025 Jul 1;15(13):1676. doi: 10.3390/diagnostics15131676.
: IPMNs are a possible cause of acute pancreatitis (AP). IPMN-associated-AP is considered a relative indication for surgery for the prevention of recurrent attacks of pancreatitis and for a hypothesized increased cancer risk. The literature is based on surgical series, and no data on the clinical features of AP associated with IPMNs and on the risk of recurrent pancreatitis and pancreatic cancer are available. This study aimed to describe the clinical/radiological features of BD-IPMN-associated AP. Moreover, BD-IPMN-associated risk factors for AP recurrence and risk of pancreatic cancer were investigated. : Patients with AP associated with branch-duct IPMN (BD-IPMN) without "worrisome- features" and "high-risk-stigmata" evaluated in a Gastroenterology Unit (University of Verona) between 1 January 2012 and 31 December 2022 were retrospectively analyzed. Cox proportional hazard models were used to analyze the time to recurrence after the first occurrence of AP. : One hundred and thirty-five patients were included, with a mean age of 55.8 ± 12.5 years. Necrosis was diagnosed in 15 patients (11.1%) and 1 patient (0.7%) was admitted to the ICU. One hundred and two (75.6%) patients had recurrent pancreatitis. The median size of the largest BD-IPMN was 8 mm (Q1-Q3: 5-12). Eighteen patients (13.3%) developed main pancreatic duct dilation ≥ 5 mm. No patients developed dilation of the main pancreatic duct ≥ 10 mm, mural nodules, thickened cystic walls, or jaundice. In the unadjusted analysis, no BD-IPMN-related features were associated with an increased risk of recurrent pancreatitis. None of the patients developed pancreatic cancer. : BD-IPMN-associated AP appears to have a benign clinical course. Cystic features related to increased risk of recurrence were not identified. The risk of cancer appears extremely low.
胰管内乳头状黏液性肿瘤（IPMNs）是急性胰腺炎（AP）的一个可能病因。IPMN相关性AP被认为是手术的相对指征，用于预防胰腺炎复发以及应对推测中增加的癌症风险。现有文献基于手术系列研究，尚无关于IPMN相关性AP的临床特征以及胰腺炎复发和胰腺癌风险的数据。本研究旨在描述分支胰管IPMN（BD-IPMN）相关性AP的临床/放射学特征。此外，还对BD-IPMN相关性AP复发风险和胰腺癌风险因素进行了研究。：对2012年1月1日至2022年12月31日期间在维罗纳大学胃肠病科评估的无“可疑特征”和“高危征象”的分支胰管IPMN（BD-IPMN）相关性AP患者进行回顾性分析。采用Cox比例风险模型分析首次发生AP后复发的时间。：纳入135例患者，平均年龄55.8±12.5岁。15例患者（11.1%）诊断为坏死，1例患者（0.7%）入住重症监护病房。102例（75.6%）患者出现胰腺炎复发。最大BD-IPMN的中位大小为8mm（四分位数间距：5-12）。18例患者（13.3%）出现主胰管扩张≥5mm。无患者出现主胰管扩张≥10mm、壁结节、囊壁增厚或黄疸。在未校正分析中，无BD-IPMN相关特征与胰腺炎复发风险增加相关。所有患者均未发生胰腺癌。：BD-IPMN相关性AP似乎具有良性临床病程。未发现与复发风险增加相关的囊性特征。癌症风险似乎极低。
