Diagnostic significance of a dilated orifice of the duodenal papilla in intraductal papillary mucinous neoplasm of the pancreas.
BACKGROUND
A dilated orifice of the duodenal papilla found during screening endoscopy or ERCP is well-known as one of the specific findings of intraductal papillary mucinous neoplasm (IPMN). However, its clinical significance is still unclear.


OBJECTIVE
To assess the diagnostic significance of a dilated orifice of the duodenal papilla and evaluate whether this could be a factor predictive of malignancy or a subtype of IPMN.


METHODS
Retrospective study.


METHODS
University hospital.


METHODS
This study involved 149 patients who underwent pancreatectomy for IPMN between January 1987 and June 2011.


METHODS
ERCP.


METHODS
The rate of malignant and intestinal type IPMNs in patients with and without papillary dilation.


RESULTS
A dilated orifice of the duodenal papilla was significantly associated with intestinal type IPMN (P < .001), but this finding could not predict the malignant grade of IPMN (P = .13). Multivariate analysis revealed that a dilated orifice was a significant factor for predicting intestinal type in both main duct (P = .01) and branch duct IPMNs (P < .001).


CONCLUSIONS
The validity of the definition of papillary dilation, selection bias, and a retrospective study.


CONCLUSIONS
A dilated orifice of the duodenal papilla could be a significant factor for predicting intestinal type IPMN. This may lead to better clinical management of patients with IPMN.
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Teppei
T
Aso
Takao
T
Ohtsuka
Noboru
N
Ideno
Hiroshi
H
Kono
Yosuke
Y
Nagayoshi
Yasuhisa
Y
Mori
Kennoki
K
Ohuchida
Junji
J
Ueda
Shunnichi
S
Takahata
Katsuya
K
Morimatsu
Shinichi
S
Aishima
Hisato
H
Igarashi
Tetsuhide
T
Ito
Kousei
K
Ishigami
Kazuhiro
K
Mizumoto
Masao
M
Tanaka
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology*; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies