Enucleation for low-grade branch duct intraductal papillary mucinous neoplasms

• Verfasst von: Kaiser, Jörg [VerfasserIn]
• Verfasst von: Alhalabi, Karam T. [VerfasserIn]
• Verfasst von: Hinz, Ulf [VerfasserIn]
• Verfasst von: Mayer, Philipp [VerfasserIn]
• Verfasst von: Tjaden, Christin [VerfasserIn]
• Verfasst von: Büchler, Markus W. [VerfasserIn]
• Verfasst von: Hackert, Thilo [VerfasserIn]
• Verfasst von: Loos, Martin [VerfasserIn]
• Titel: Enucleation for low-grade branch duct intraductal papillary mucinous neoplasms
• Titelzusatz: long-term follow-up
• Verf.angabe: Joerg Kaiser, Karam T. Alhalabi, Ulf Hinz, Philipp Mayer, Christine Tjaden, Markus W. Büchler, Thilo Hackert, Martin Loos
• E-Jahr: 2022
• Jahr: [September 2022]
• Umfang: 7 S.
• Illustrationen: Diagramme
• Fussnoten: Gesehen am 04.01.2023
• Titel Quelle: Enthalten in: Surgery
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 1995
• Jahr Quelle: 2022
• Band/Heft Quelle: 172(2022), 3 vom: Sept., Seite 968-974
• ISSN Quelle: 1532-7361
• DOI: doi:10.1016/j.surg.2022.04.035
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1830310925

Abstract

Background - Pancreatic enucleation allows resection of branch-duct intraductal papillary mucinous neoplasms with full parenchyma preservation. The aim of this study was to assess intraductal papillary mucinous neoplasms recurrence and functional outcomes during long-term follow-up after enucleation. - Methods - Patient characteristics, as well as radiologic and clinicopathologic follow-up data of patients who underwent enucleation for branch-duct intraductal papillary mucinous neoplasms between 2004 and 2014, were analyzed. Quality of life was assessed using the EORTC QLQ-C30 and QLQ-PAN26 questionnaires. - Results - Seventy-four patients underwent enucleation for low-grade branch-duct intraductal papillary mucinous neoplasms in 71 and high-grade branch-duct intraductal papillary mucinous neoplasms in 3 patients. Long-term follow-up data were available for 66 patients (89%; median follow-up: 87 months). Radiologic imaging (n = 56) showed intraductal papillary mucinous neoplasm recurrence in 10 patients (18%) including local recurrence at the site of enucleation in 3 patients (5%) and new onset intraductal papillary mucinous neoplasms manifestation in 7 patients (13%) at a distant site in the pancreatic remnant. Four patients (6%) underwent reoperation. Two of these patients had intraductal papillary mucinous neoplasm-associated carcinoma, one of them at the enucleation site. During the follow-up period, no intraductal papillary mucinous neoplasm-related deaths occurred and no new onsets of insulin-dependent diabetes mellitus were observed. QLQ-C30 revealed a global health status of 66.0% and overall functioning and symptom scores of 81.0% and 22.8%, respectively. Additionally, QLQ-PAN26 showed an overall symptom score of 26.5%. - Conclusion - Enucleation is an organ-preserving surgical treatment option for low-grade branch-duct intraductal papillary mucinous neoplasms with low local recurrence risk and excellent functional long-term outcome. However, postoperative life-long follow-up must be performed as for any type of partial pancreatectomy for intraductal papillary mucinous neoplasms due to the risk of recurrence and potential malignancy.