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World J Gastrointest Surg. Oct 27, 2010; 2(10): 342-346
Published online Oct 27, 2010. doi: 10.4240/wjgs.v2.i10.342
Differences between main-duct and branch-duct intraductal papillary mucinous neoplasms of the pancreas
Roberto Salvia, Stefano Crippa, Stefano Partelli, Giulia Armatura, Giuseppe Malleo, Marina Paini, Antonio Pea, Claudio Bassi
Roberto Salvia, Stefano Crippa, Stefano Partelli, Giulia Armatura, Giuseppe Malleo, Marina Paini, Antonio Pea, Claudio Bassi, Department of Surgery - General Surgery B, “GB Rossi” Hospital, University of Verona, 10-37134 Verona, Italy
Author contributions: Salvia R, Crippa S, Partelli S, Paini M, Pea A and Malleo G analyzed the data; Salvia R, Crippa S and Armatura G wrote the paper; Bassi C reviewed and supervised the work.
Correspondence to: Claudio Bassi, MD, Department of Surgery - Chirurgia Generale B, Policlinico “GB Rossi” Hospital, University of Verona, Piazzale LA Scuro, 10-37134 Verona, Italy. claudio.bassi@univr.it
Telephone: +39-45-8124552 Fax: +39-045-8124826
Received: May 18, 2010
Revised: September 17, 2010
Accepted: September 24, 2010
Published online: October 27, 2010
Abstract

In the last decade, intraductal papillary mucinous neoplasms (IPMNs) have become commonly diagnosed. From a morphological standpoint, they are classified in main-duct IPMNs (MD-IPMNs) and branch-duct IPMNs (BD-IPMNs), depending on the type of involvement of the pancreatic ductal system by the neoplasm. Despite the fact that our understanding of their natural history is still incomplete, recent data indicate that MD-IPMNs and BD-IPMNs show significant differences in terms of biological behaviour with MD-IPMNs at higher risk of malignant degeneration. In the present paper, clinical and epidemiological characteristics, rates of malignancy and the natural history of MD-IPMNs and BD-IPMNs are analyzed. The profile of IPMNs involving both the main pancreatic duct and its side branches (combined-IPMNs) are also discussed. Finally, general recommendations for management based on these differences are given.

Keywords: Intraductal papillary mucinous neoplasms, Branch-duct, Main-duct, Malignancy, Surgery, Follow-up, Nodules, Combined type