[Organ-preserving resection of the pancreaticoduodenal region in the treatment of intraductal papillary mucinous tumors].
BACKGROUND
The standard surgical procedure for intraductal papillary mucinous neoplasms of the main duct (IPMN-M) or side branch ducts (IPMN-Br) is pancreaticoduodenectomy. IPMN-BR is a more indolent disease with a lower incidence of malignancy.


OBJECTIVE
To evaluate the usefulness of organ-preserving pancreatic resections (OPPR) including duodenum-preserving pancreatic head resection (DPHR) and pancreatic head resection with segmental duodenectomy (PHRSD) in patients with IPMN-BR.


METHODS
Surgical outcomes were evaluated in eight IPMN-Br patients: DPHR was performed in 4 patients and PHRSD was performed in 4 patients. In addition, 13 IPMN patients with Whipple resections were included in the analysis.


RESULTS
The incidence of postoperative complications was 38% after Whipple resection, 100% after DPHR and 25% after PHRSD. The mean length of hospital stay was 27 days after DPHR, 22 days after Whipple resection and 16 days after PHRSD. Invasive IPMN was found in 38% of the patients in the Whipple group, and noninvasive IPMN was found in 100% of patients who underwent organ-preserving surgery.


CONCLUSIONS
Pancreaticoduodenectomy remains the treatment of choice in patients with invasive IPMN. PHRSD appears to be a useful procedure for IPMN-Br located in the head of the pancreas.
Fernández-Cruz
Laureano
L
Departamento de Cirugía, ICMD, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España. lfcruz@clinic.ub.es
Olvera
Cristóbal
C
López-Boado
Miguel Angel
MA
Bollo
Jesús
J
Romero
Juan
J
Comas
Jaume
J
D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000473:pathology / Q000601:surgery; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010179:Pancreas / Q000473:pathology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D016896:Treatment Outcome