Asymptomatic pancreatic lesions(APL) are a commonly encountered problem in today's pancreatic surgical practices.Current literature regarding etiologies and incidence of APLs,particularly intraductal papillary muc...Asymptomatic pancreatic lesions(APL) are a commonly encountered problem in today's pancreatic surgical practices.Current literature regarding etiologies and incidence of APLs,particularly intraductal papillary mucinous neoplasm(IPMN),is presented.APLs constitute a wide spectrum of pathology(solid/cystic,benign/premalignant/malignant) but,overall,IPMN is now the most common diagnosis.The Sendai Guidelines and their function as a basis for risk stratification in branch duct IPMN are presented.The importance of traditionally analyzed cyst characteristics including size,presence of mucin or nodules and cyst fluid aspirate as indicators of malignancy is emphasized,noting also the potential correlation of main duct dilatation,thickened septae and elevated cyst fluid CEA with increased risk of malignancy.Current complication rates after resection of APLs are reviewed and found to be generally equivalent to those for symptomatic resections.A potential multidisciplinary treatment strategy is offered considering the costs of surgery versus repeated imaging or follow up endoscopy for these lesions.The decision for intervention is ultimately based on the Sendai Guidelines in the context of the individual patient.展开更多
Intraductal papillary mucinous neoplasm(IPMN) is a disease in evolution.Since its first description almost 30 years ago,a better understanding of the disease has steadily accrued.Yet,there are numerous challenges stil...Intraductal papillary mucinous neoplasm(IPMN) is a disease in evolution.Since its first description almost 30 years ago,a better understanding of the disease has steadily accrued.Yet,there are numerous challenges still for clinicians who treat this fascinating disease.A group of leading content experts on IPMN was assembled and charged with presenting cutting-edge knowledge on various topics for which they have considerable experience.This manuscript provides an historical perspective of both clinical and biological quandaries that have been resolved to date.Furthermore,it poses new avenues for investigation while highlighting the contributions of the various authors to this collective review.展开更多
文摘Asymptomatic pancreatic lesions(APL) are a commonly encountered problem in today's pancreatic surgical practices.Current literature regarding etiologies and incidence of APLs,particularly intraductal papillary mucinous neoplasm(IPMN),is presented.APLs constitute a wide spectrum of pathology(solid/cystic,benign/premalignant/malignant) but,overall,IPMN is now the most common diagnosis.The Sendai Guidelines and their function as a basis for risk stratification in branch duct IPMN are presented.The importance of traditionally analyzed cyst characteristics including size,presence of mucin or nodules and cyst fluid aspirate as indicators of malignancy is emphasized,noting also the potential correlation of main duct dilatation,thickened septae and elevated cyst fluid CEA with increased risk of malignancy.Current complication rates after resection of APLs are reviewed and found to be generally equivalent to those for symptomatic resections.A potential multidisciplinary treatment strategy is offered considering the costs of surgery versus repeated imaging or follow up endoscopy for these lesions.The decision for intervention is ultimately based on the Sendai Guidelines in the context of the individual patient.
文摘Intraductal papillary mucinous neoplasm(IPMN) is a disease in evolution.Since its first description almost 30 years ago,a better understanding of the disease has steadily accrued.Yet,there are numerous challenges still for clinicians who treat this fascinating disease.A group of leading content experts on IPMN was assembled and charged with presenting cutting-edge knowledge on various topics for which they have considerable experience.This manuscript provides an historical perspective of both clinical and biological quandaries that have been resolved to date.Furthermore,it poses new avenues for investigation while highlighting the contributions of the various authors to this collective review.
