Brunner M, Kersting S, Grützmann R, Weber G (2017)
Publication Type: Journal article
Publication year: 2017
Book Volume: 88
Pages Range: 918-926
Journal Issue: 11
DOI: 10.1007/s00104-017-0495-z
Due to improvements in imaging modalities the diagnosis of branch duct intraductal papillary mucinous neoplasms (BD-IPMN) has been significantly increased in recent years. A BD-IPMN is frequently diagnosed as an incidental finding in asymptomatic patients. The optimal management of BD-IPMN is the subject of controversial discussions. Numerous studies have shown that an individualized therapeutic strategy with a follow-up observation of most BD-IPMNs is feasible and safe, considering age, comorbidities and patient preference. An accurate evaluation of BD-IPMN with a detailed anamnesis, high-resolution imaging techniques and endoscopic ultrasound is necessary. Symptomatic patients as well as patients with so-called high-risk stigmata should undergo resection. Asymptomatic patients with so-called worrisome features can either undergo surveillance or surgical resection, taking age and comorbidities into account. For BD-IPMN patients without high-risk stigmata and worrisome features and showing no symptoms, surveillance of the pancreatic lesion is the preferred approach. The high prevalence of BD-IPMN, limitations in differential diagnostics, an overestimation of the risk of malignancy due to an overrepresentation of symptomatic and suspected BD-IPMN in resected cohorts, an overestimated role of BD-IPMN as precursor lesions for pancreatic carcinoma and evidence of the safety of follow-up surveillance, underline the enormous importance of surveillance. Based on this and considering the background of a notable mortality and morbidity of pancreatic surgery, aggressive management with prophylactic surgical resection is not justified for all BD-IPMN, in particular for low-risk lesions.
APA:
Brunner, M., Kersting, S., Grützmann, R., & Weber, G. (2017). Branch duct intraductal papillary mucinous neoplasm - contra resection. Chirurg, 88(11), 918-926. https://doi.org/10.1007/s00104-017-0495-z
MLA:
Brunner, Michaela, et al. "Branch duct intraductal papillary mucinous neoplasm - contra resection." Chirurg 88.11 (2017): 918-926.
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