Abstract:

Diagnosis and therapy of intraductal papillary mucinous tumors of the pancreas. Hu Xiangui,Chen Zhiyong,Zhang Yijie,et al.Department of General Surgery,Changhai Hospital,Second Military Medical University,Shanghai 200433,China Abstract Objective To get a better understanding of intraductal papillary mucinous tumors of the pancreas(IPMTs) so as to improve diagnosis and treatment of the condition. Methods The features,imaging manifestation and pathological findings of fifteen cases with IPMTs were reviewed. Results There were 12 male and 3 female was female in this series,with age ranging from 33 to 76 years (average 58 years).The common complaint was upper abdominal pain.BUltrasound and CT scan were found different extent dilatation of the main pancreatic duct and cystic and solid lesions in all patients.ERCP was undertaken on 9 patients,and in 7 was seen the swelling of the papilla of Vater,massive mucin production.twelve cases underwent pancreaticoduodenectomy and，1 case underwent distal pancreatectomy and 1 case underwent total pancreatectomy. Postoperative pathological diagnosis:3 case of intraductal papillary mucinous adenocarcinoma,6 cases of intraductal papillary mucinous adenoma with partial cancerization,3 case of intraductal papillary mucinous adenoma with atypical hyperplasia,2 cases of intraductal papillary mucinous adenoma.All patients were healthy after operation except that 1 case died from heptic metastasis and 1 survived 13 years. Conclusion IPMTs should be taken into account when cystic and solid lesions with a distended main pancreatic duct was found.Diagnosis can be confirmed when ERCP show enlarged papilla with its expulsion of mucous material.Resection is the most effective treatment with better prognosis.