title: Long-term clinical and imaging follow-up of nonoperated branch duct form of intraductal papillary mucinous neoplasms of the pancreas.
abstract: OBJECTIVE
  The aim of our study was to perform a 10-year imaging and clinical prospective follow-up of patients with nonoperated branch duct (BD) intraductal papillary mucinous neoplasms (IPMNs) of the pancreas.
  
  
  METHODS
  Forty-nine patients with BD-IPMN who displayed a low probability for malignancy were followed up including a clinical component and a series of imaging techniques such as computed tomography, magnetic resonance cholangiopancreatography, and endoscopic ultrasonography.
  
  
  RESULTS
  After a mean follow-up period of 77 months, 77.5% of patients remained free of symptoms. An increase in the size and number of BD cysts without mural nodules and with no significant increase of main duct size occurred in 18 patients at an average interval of 47 months. Five patients were operated on owing to recurrent pancreatitis and/or an increase in the size of either cysts or the main duct (mean time delay after diagnosis: 20 months). Pathologically, they were diagnosed as benign adenoma (n = 1) or borderline (n = 4).
  
  
  CONCLUSIONS
  Our long-term clinical and imaging follow-up indicated that none of the patients with BD-IPMNs developed malignancy. Therefore, BD-IPMNs with no signs of malignancy should be managed conservatively. We propose that following a 2-year patient follow-up, biannual imaging follow-ups could be sufficient.
authors.affiliation: Department of Gastroenterology, University Hospital Center Rangueil-Larrey, Toulouse, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Arlix
authors.forename: Barbara
authors.initials: B
authors.lastname: Bournet
authors.forename: Philippe
authors.initials: P
authors.lastname: Otal
authors.forename: Guillaume
authors.initials: G
authors.lastname: Canevet
authors.forename: Aldine
authors.initials: A
authors.lastname: Thevenot
authors.forename: Sylvain
authors.initials: S
authors.lastname: Kirzin
authors.forename: Nicolas
authors.initials: N
authors.lastname: Carrere
authors.forename: Bertrand
authors.initials: B
authors.lastname: Suc
authors.forename: Jacques
authors.initials: J
authors.lastname: Moreau
authors.forename: Jean
authors.initials: J
authors.lastname: Escourrou
authors.forename: Louis
authors.initials: L
authors.lastname: Buscail
mesh_terms: D000236:Adenoma / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D016009:Chi-Square Distribution; D049448:Cholangiopancreatography, Magnetic Resonance; D003952:Diagnostic Imaging / Q000379:methods; D018450:Disease Progression; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed