Intraductal papillary neoplasms of the pancreas. An analysis of clinicopathologic features and outcomes at the hospital nacional guillermo almenara irigoyen. Lima – Perú

Abstract

Introduction: Intraductal papillary mucinous neoplasm (IPMN) is a mucin producing neoplasm that arises in the main pancreatic duct and/or its branches. The objective of this study is to analyze retrospectively the clinical, radiologic and pathologic features as well as the surgical results of the patients with diagnosis of IPMN. Methods: Patients with diagnosis of IPMN who underwent surgery were identified from January 2006 to September 2015, using the prospective data base of the Pancreas service at HNGAI. Results: A total of 16 patients were found (12 females and 4 males). The mean age was 67.68 years. 3 were main duct type IPMN, 7 branch type and 6 mixed type. The pain was the most frequent symptom (87.5%), 25% had pancreatitis. For the diagnosis 100% had CT scan, 90% MRI. 11 patients underwent pancreaticoduodenectomy, 4 distal pancreatectomy (1 laparoscopic) and 1 exploratory laparotomy. 2 patients had type C pancreatic fistula. 2 patients underwent reoperation, 1 had prolonged ICU stay (because of an intrahospitalary pneumonia), and 1 died. 7 patients had low grade dysplasia, 2 moderate dysplasia, 1 high grade dysplasia, 5 invasive carcinoma and 1 patient had lesion with low grade dysplasia and one concomitant adenocarcinoma of the pancreas. Conclusions: This entity is present in our country being more common in women. The branch type IPMN is the most frequent type. The pancreatic fistula is the most important complication and the mortality rate is low. The IPMN's malignacy potential founded was high.