title: Comparison of efficacy of enucleation and pancreaticoduodenectomy for small (<3 cm) branch duct type intraductal papillary mucinous neoplasm located at the head of pancreas and the uncinate process.
abstract: OBJECTIVE
  Accurate indications and the extent of surgery for branch duct intraductal papillary mucinous neoplasm (IPMN) of the pancreas are still debatable. In particular, small tumor is located at the head portion of pancreas presents a dilemma. The purpose of this study is to compare the efficacy of enucleation (EN) with that of pancreaticoduodenectomy (PD) in patients with small (2 cm<size<3 cm) branch duct IPMN located at the head of pancreas or uncinate process.
  
  
  METHODS
  Among 155 patients who underwent pancreatic surgery due to pancreatic cystic tumors between January 2000 and December 2007 at Yonsei University Health System in Seoul, Korea, 14 patients with small (2 cm<size<3 cm) branch duct IPMN located at the head of pancreas or uncinate process were included in this study. Ten patients underwent PD, and four patients underwent EN. We compared short term surgical outcomes between the two groups. Correlation of the variables was analyzed using Mann-Whitney test and Fisher's exact test (SPSS Window 12.0). p-values less than 0.05 were considered significant.
  
  
  RESULTS
  The average age was 62.21 years (±6.71 years) and consisted of 8 men and 6 women. The mean operation time and blood loss were significantly lower in EN group. There were no significant differences in other surgical morbidities.
  
  
  CONCLUSIONS
  The result suggests that enucleation for small branch duct IPMN located at the head of pancreas or uncinate process is feasible and as safe as PD, despite a high rate of minor complications.
authors.affiliation: Pancreatobiliary Cancer Clinic, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ho Kyoung
authors.initials: HK
authors.lastname: Hwang
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Park
authors.forename: Jae Keun
authors.initials: JK
authors.lastname: Kim
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Park
authors.forename: Shin Il
authors.initials: SI
authors.lastname: Cho
authors.forename: Dong Sup
authors.initials: DS
authors.lastname: Yoon
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery*; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome