Diagnosis And Treatment Of 26 Patients With Intraductal Papillary Mucinous Neoplasms Of The Pancreas

Background In recent years intraductal papillary mucinous neoplasms of the pancreas (IPMN) has been recognized a pancreatic cystic tumors. IPMNs originated in the pancreatic duct and the branch duct epithelium. Excessive secretion of of mucus cause pancreatic duct dilatation and its branches. World Health Organization (WHO) universal naming IPMN according to morphological and pathological features. Commonly found in 60 to 70 years, and IPMN had thought occurred in elderly men.Now research shows that men and women ratio of about 1:1. IPMNs are characterized by low malignancy, rarely invasion of surrounding structures, slow progression. In recent years, many of the diseases were reported in the literature. NOW we got a better understanding of their treatment, but IPMN diagnosis and treatment remains controversial.Objective A retrospective study was conducted in 26cases of patients who accepted diagnosis and treatment for IPMN form Januaruy,2006 to December,2015. A discussion of IPMN diagnostic and treatment strategies, consequently providing reference for clinical treatment.Methods A retrospective study was conducted in 26cases of patients who accepted diagnosis and treatment for IPMN form Januaruy,2006 to December,2015. Making a discussion about the patient’s clinical symptoms and laboratory and imaging and surgical and pathological type. To summarize the clinical characteristics of IPMN and analyzed surgical treatment, investigate the prognostic factors.Results Among the 26 patients,16 were male,12 were female. The average age was(58.7±9.5)years old.years. Clinical manifestations of abdominal pain in 23 cases, weight loss in 5 cases jaundice in 4 cases, asymptomatic in 4 cases. According to WHO IPMN type,9 cases in which the main pancreatic duct, branch duct in 11 cases, mixed type in 6 cases. All patients underwent surgery, Pancreaticoduodenectomy in 16 cases.3 cases underwent pancreaticoduodenectomy with portal vein resection.4 patients underwent duodenum preserving pancreatic head resection.4 patients underwent distal pancreatectomy. No patient died in perioperative period, and the median length of hospital stay after surgery was 15.6d. Postoperative pathological examination revealed 5 adenoma,9 moderate-grade dysplasia,3 high-grade dysplasia,9 invasive carcinoma. Non-invasive cases without lymph node involvement or vascular. Three cases of invasive cancer patients with lymph node metastasis. Cases of non-invasive survived so far without recurrence.The mean follow up period of the invasive tumors was 36 months, with 1 death.Conclusion IPMN with distinct clinical and pathological features, radiological examination is an important diagnostic method. Early resection is essential for improving survival. Surgical resection should be performed in patients with IPMN. Long-term follow-up is necessary for patients with IPMNs after resection.