Pagina Iniziale » Pancreas » IPMN
IPMN
Tumori Papillari Mucinosi del Pancreas
Neoplasie Intraduttali Papillari Mucinose del Pancreas
Cosa sono gli IPMN del pancreas?
Risposta: IPMN è l’abbreviazione del termine inglese “Intraductal Papillary Mucinous Neoplasm” che in italiano significa “neoplasie intraduttali papillari mucinose”.
Sono neoformazioni descritte per la prima volta nel 1982 (Ohhashi KMY, Takekoshi T. Four cases of ‘mucin producing’ cancer of the pancreas on specific findings of the papilla of Vater. Prog Diag Endosc. 1982;20:348–351.) e che fanno parte dei tumori cistici del pancreas.
Questi tumori sono piuttosto rari ed insorgono prevalentemente in pazienti intorno ai 60-70 anni, senza differenza significativa tra maschi e femmine.
Sono caratterizzati dalla proliferazione di cellule di tipo mucinoso che, all’interno dei dotti pancreatici, formano delle proiezioni papillari, da cui il nome.
I dotti pancreatici coinvolti sono quindi ovviamente dilatati (dilatazioni cistiche) e contengono mucina.
Quanti e quali tipi di IPMN ci sono?
Risposta: Ci sono sostanzialmente tre tipi di IPMN:
- IPMN del dotto pancreatico principale (o IPMN centrali), caratterizzati da una dilatazione segmentaria o diffusa del dotto pancreatico principale maggiore di 5 mm senza altre cause evidenti di ostruzione. Questi IPMN hanno un alto potenziale aggressivo (fino al 60-70%) e presentano una percentuale di carcinoma invasivo intorno al 40%. In lingua inglese questi IPMN vengono definiti come “main duct (MD)-IPMN”.
- IPMN dei dotti pancreatici secondari (o IPMN periferici), a basso-medio potenziale aggressivo (fino al 20-25%) e con una percentuale di carcinoma invasivo intorno al 10%. Spesso gli IPMN periferici sono multifocali (sono cioè dilatazioni multiple cistiche segmentarie in diverse porzioni del pancreas). In lingua inglese questi IPMN vengono definiti come “branch duct (BD)-IPMN”;
- IPMN di tipo misto (IPMN misti), in cui è presente il simultaneo coinvolgimento neoplastico del dotto principale e dei dotti secondari, e che hanno comportamento biologico e prognosi simile alle IPMN centrali. Gli IPMN misti sono spesso multifocali. In lingua inglese questi IPMN vengono definiti come “mixed type (MT)-IPMN”
Gli IPMN sono tumori maligni?
Risposta: Gli IPMN hanno uno spettro di aggressività biologica molto ampio, da benigno a francamente maligno.
Secondo le Linee Guida Europee, sono fortemente predittivi della presenza di un tumore maligno (e sono indicazioni assolute ad un intervento chirurgico di resezione del pancreas):
- la presenza dell’ittero (la colorazione gialla della pelle del paziente);
- la presenza di noduli intramurali ≥ 5 mm che assumono contrasto durante gli esami radiologici o hanno una componente solida;
- un esame citologico positivo;
- la dilatazione del dotto pancreatico principale ≥ 10 mm.
Sono comunque associati ad un rischio aumentato di avere una displasia di alto grado o un cancro (e sono indicazioni relative all’esecuzione di un intervento chirurgico di resezione pancreatica):
- la dilatazione del dotto principale fra 5 e 9,9 mm;
- la crescita volumetrica della cisti ≥ 5 mm/anno;
- un valore di CA 19-9 aumentato (>37 U/mL);
- la presenza di sintomi causati dell’IPMN;
- la presenza di noduli intramurali <5 mm che assumono contrasto agli esami radiologici;
- il diametro della cisti ≥ 40 mm
Come si fanno a vedere e a studiare gli IPMN?
Risposta: gli IPMN si studiano con la TC o con la Risonanza (RM).
La risonanza è più sensibile nel rilevare i rapporti fra IPMN e i dotti pancreatici, la presenza di noduli intramurali e i setti interni. La RM è migliore nel vedere se l’IPMN è singolo o multiplo all’interno del pancreas.
Nello studio per la definizione di un paziente con IPMN è fortemente consigliata l’esecuzione di una ecografia per via endoscopica (ecoendoscopia).
A causa dell’assenza di sintomi riconoscibili, bisogna però ricordare che gli IPMN vengono spesso diagnosticati durante accertamenti clinici svolti per altri motivi.
Gli IPMN devono essere tutti operati?
Risposta: NO. Bisogna verificare le caratteristiche dell’IPMN del singolo malato. Molti IPMN possono semplicemente essere seguiti nel tempo.
I pazienti portatori di IPMN centrali (MD-IPMN) e che non presentano controindicazioni di carattere generale all’esecuzione di un’operazione chirurgica dovrebbero eseguire di regola la resezione del pancreas.
L’esecuzione di un intervento di resezione per gli IPMN centrali (MD-IPMN) è ormai universalmente accettata a causa dell’alta possibilità di che l’IPMN sia già maligno o che lo possa diventare.
Le stesse considerazioni valgono anche per gli IPMN di tipo misto (MT-IPMN).
I pazienti portatori di IPMN dei dotti secondari (BD-IPMN) che presentano i seguenti criteri:
- la presenza dell’ittero (la colorazione gialla della pelle del paziente);
- la presenza di noduli intramurali ≥ 5 mm che assumono contrasto durante gli esami radiologici o hanno una componente solida;
- un esame citologico positivo;
- la dilatazione del dotto pancreatico principale ≥ 10 mm.
devono essere considerati avere una indicazione assoluta all’intervento e quindi essere operati.
I pazienti portatori di IPMN dei dotti secondari (BD-IPMN) che presentano invece i seguenti criteri:
- la dilatazione del dotto principale fra 5 e 9,9 mm;
- la crescita volumetrica della cisti ≥ 5 mm/anno;
- un valore di CA 19-9 aumentato (>37 U/mL);
- la presenza di sintomi causati dell’IPMN;
- la presenza di noduli intramurali <5 mm che assumono contrasto agli esami radiologici;
- il diametro della cisti ≥ 40 mm
devono essere considerati avere una indicazione relativa all’intervento e quindi essere gestiti conseguentemente, anche tenendo conto delle loro condizioni generali.
Le neoformazioni cistiche del pancreas di natura non ben definita, che non hanno fattori di rischio per sviluppare un tumore maligno del pancreas e misurano < 15 mm in diametro, dovrebbero essere riesaminate con la radiologia (Risonanza e/o ecoendoscopia + dosaggio del CA 19-9 nel sangue) dopo 1 anno. Se rimangono stabili per 3 anni, allora la periodicità degli esami dovrebbe essere portata a ogni due anni.
Le cisti di diametro ≥15 mm dovrebbero invece essere valutate ogni 6 mesi per il primo anno dopo la prima diagnosi (con Risonanza e/o ecoendoscopia + dosaggio del CA 19-9 nel sangue) e quindi ogni anno successivamente.
Duodeno cefalo pancreasectomia
Linee Guida per Malattie del Pancreas
- Ultimo aggiornamento della pagina: 03/10/2023
Linee Guida per la Diagnosi ed il Trattamento degli IPMN e dei Tumori Cistici del Pancreas
2018
Chiaro M D; Besselink M G; Scholten L; Bruno M J; Cahen D L; Gress T M; Hooft J E; Lerch M M; Mayerle J; Hackert T; Satoi S; Zerbi A; Cunningham D; Angelis C D; Giovannini M; de-Madaria E; Hegyi P; Rosendahl J; Friess H; Manfredi R; Lévy P; Real F X; Sauvanet A; Hilal M A; Marchegiani G; Esposito I; Ghaneh P; Engelbrecht M R W; Fockens P; Huijgevoort N C M; Wolfgang C; Bassi C; Gubergrits N B; Verbeke C; Klöppel G; Scarpa A; Zamboni G; Lennon A M; Sund M; Kartalis N; Grenacher L; Falconi M; Arnelo U; Kopchak K V; Oppong K; McKay C; Hauge T; Conlon K; Adham M; Ceyhan G O; Salvia R; Dervenis C; Allen P; Paye F; Bartsch D K; Löhr M; Mutignani M; Laukkarinen J; Schulick R; Valente R; Seufferlein T; Capurso G; Siriwardena A; Neoptolemos J P; Pukitis A; Segersvärd R; Aghdassi A; Andrianello S; Bossuyt P; Bülow R; Cárdenas-Jaén K; Cortegoso P; Fontana M; Haeberle L; Heckler M; Litvin A; Mann K; Michalski C; Michl P; Nappo G; Perri G; Persson S; Scheufele F; Sclafani F; Schmidt M; Venezia L; Volker F; Vullierm M -P; Wüsten L
European evidence-based guidelines on pancreatic cystic neoplasms Journal Article
In: Gut, vol. 67, no 5, pp. 789 – 804, 2018, ISSN: 00175749, (Cited by: 506; All Open Access, Green Open Access, Hybrid Gold Open Access).
@article{DelChiaro2018789,
title = {European evidence-based guidelines on pancreatic cystic neoplasms},
author = {Marco Del Chiaro and Marc G. Besselink and Lianne Scholten and Marco J. Bruno and Djuna L. Cahen and Thomas M. Gress and Jeanin E. Hooft and Markus M. Lerch and Julia Mayerle and Thilo Hackert and Sohei Satoi and Alessandro Zerbi and David Cunningham and Claudio De Angelis and Marc Giovannini and Enrique de-Madaria and Peter Hegyi and Jonas Rosendahl and Helmut Friess and Riccardo Manfredi and Philippe Lévy and Francisco X. Real and Alain Sauvanet and Mohammed Abu Hilal and Giovanni Marchegiani and Irene Esposito and Paula Ghaneh and Marc R. W. Engelbrecht and Paul Fockens and Nadine C. M. Huijgevoort and Christopher Wolfgang and Claudio Bassi and Natalya B. Gubergrits and Caroline Verbeke and Günter Klöppel and Aldo Scarpa and Giuseppe Zamboni and Anne Marie Lennon and Malin Sund and Nikolaos Kartalis and Lars Grenacher and Massimo Falconi and Urban Arnelo and Kostantin V. Kopchak and Kofi Oppong and Colin McKay and Truls Hauge and Kevin Conlon and Mustapha Adham and Güralp O. Ceyhan and Roberto Salvia and Christos Dervenis and Peter Allen and François Paye and Detlef K. Bartsch and Matthias Löhr and Massimiliano Mutignani and Johanna Laukkarinen and Richard Schulick and Roberto Valente and Thomas Seufferlein and Gabriele Capurso and Ajith Siriwardena and John P. Neoptolemos and Aldis Pukitis and Ralf Segersvärd and A. Aghdassi and S. Andrianello and P. Bossuyt and R. Bülow and K. Cárdenas-Jaén and P. Cortegoso and M. Fontana and L. Haeberle and M. Heckler and Andrey Litvin and K. Mann and C. Michalski and P. Michl and G. Nappo and G. Perri and S. Persson and F. Scheufele and F. Sclafani and M. Schmidt and L. Venezia and F. Volker and M. -P. Vullierm and L. Wüsten},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85046420272&doi=10.1136%2fgutjnl-2018-316027&partnerID=40&md5=40099ac83d65a44c12043d655e85a2ae},
doi = {10.1136/gutjnl-2018-316027},
issn = {00175749},
year = {2018},
date = {2018-01-01},
urldate = {2018-01-01},
journal = {Gut},
volume = {67},
number = {5},
pages = {789 – 804},
publisher = {BMJ Publishing Group},
abstract = {Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring <40 mm without an enhancing nodule. Relative indications for surgery in IPMN include a main pancreatic duct (MPD) diameter between 5 and 9.9 mm or a cyst diameter ≥40 mm. Absolute indications for surgery in IPMN, due to the high-risk of malignant transformation, include jaundice, an enhancing mural nodule >5 mm, and MPD diameter >10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN. © Article author(s) 2018. All rights reserved.},
note = {Cited by: 506; All Open Access, Green Open Access, Hybrid Gold Open Access},
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2017
Tanaka M; Castillo C F; Kamisawa T; Jang J Y; Levy P; Ohtsuka T; Salvia R; Shimizu Y; Tada M; Wolfgang C L
Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas Journal Article
In: Pancreatology, vol. 17, no 5, pp. 738 – 753, 2017, ISSN: 14243903, (Cited by: 748).
@article{Tanaka2017738,
title = {Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas},
author = {Masao Tanaka and Carlos Fernández-del Castillo and Terumi Kamisawa and Jin Young Jang and Philippe Levy and Takao Ohtsuka and Roberto Salvia and Yasuhiro Shimizu and Minoru Tada and Christopher L. Wolfgang},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85025443370&doi=10.1016%2fj.pan.2017.07.007&partnerID=40&md5=354dbe5a290d35fdad7d0f08fbceac83},
doi = {10.1016/j.pan.2017.07.007},
issn = {14243903},
year = {2017},
date = {2017-01-01},
urldate = {2017-01-01},
journal = {Pancreatology},
volume = {17},
number = {5},
pages = {738 – 753},
publisher = {Elsevier B.V.},
abstract = {The management of intraductal papillary mucinous neoplasm (IPMN) continues to evolve. In particular, the indications for resection of branch duct IPMN have changed from early resection to more deliberate observation as proposed by the international consensus guidelines of 2006 and 2012. Another guideline proposed by the American Gastroenterological Association in 2015 restricted indications for surgery more stringently and recommended physicians to stop surveillance if no significant change had occurred in a pancreatic cyst after five years of surveillance, or if a patient underwent resection and a non-malignant IPMN was found. Whether or not it is safe to do so, as well as the method and interval of surveillance, has generated substantial debate. Based on a consensus symposium held during the meeting of the International Association of Pancreatology in Sendai, Japan, in 2016, the working group has revised the guidelines regarding prediction of invasive carcinoma and high-grade dysplasia, surveillance, and postoperative follow-up of IPMN. As the working group did not recognize the need for major revisions of the guidelines, we made only minor revisions and added most recent articles where appropriate. The present guidelines include updated information and recommendations based on our current understanding, and highlight issues that remain controversial or where further research is required. © 2017 IAP and EPC},
note = {Cited by: 748},
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pubstate = {published},
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}
2015
Vege S S; Ziring B; Jain R; Moayyedi P
American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts Journal Article
In: Gastroenterology, vol. 148, no 4, pp. 819 – 822, 2015, ISSN: 00165085, (Cited by: 561).
@article{Vege2015819,
title = {American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts},
author = {Santhi Swaroop Vege and Barry Ziring and Rajeev Jain and Paul Moayyedi},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84925355233&doi=10.1053%2fj.gastro.2015.01.015&partnerID=40&md5=6dad6238ed5621956223a70a0f329bab},
doi = {10.1053/j.gastro.2015.01.015},
issn = {00165085},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {Gastroenterology},
volume = {148},
number = {4},
pages = {819 – 822},
publisher = {W.B. Saunders},
abstract = {This article has an accompanying continuing medical education activity on page e12. Learning Objective: At the conclusion of this exercise, the learner will understand the approach to counseling patients regarding the optimal method and frequency of radiologic imaging, indications for invasive tests like endoscopic ultrasonography (EUS) and surgery, select patients for follow-up after surgery, decide the duration of such follow-up, and decide when to stop surveillance for those with and without surgery. © 2015 by the AGA Institute.},
note = {Cited by: 561},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2014
Buscarini E; Pezzilli R; Cannizzaro R; Angelis C D; Gion M; Morana G; Zamboni G; Arcidiacono P; Balzano G; Barresi L; Basso D; Bocus P; Calculli L; Capurso G; Canzonieri V; Casadei R; Crippa S; D'Onofrio M; Frulloni L; Fusaroli P; Manfredi G; Pacchioni D; Pasquali C; Rocca R; Ventrucci M; Venturini S; Villanacci V; Zerbi A; Falconi M; Albarello L; Camellini L; Cantù P; Conigliaro R; Costamagna G; Favero G D; Blanco G D V; Sebastiano P D; Fabbri C; Federici P; Funel N; Galli A; Gabbrielli A; Graziani R; Guadagnini T; Laghi A; Macarri G; Magnolfi F; Marzioni M; Monica F; Muscatiello N; Mutignani M; Pisani A; Scarano E; Serra C; Spada M; Visconti M; Zambelli A
Italian consensus guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms Journal Article
In: Digestive and Liver Disease, vol. 46, no 6, pp. 479 – 493, 2014, ISSN: 15908658, (Cited by: 86; All Open Access, Green Open Access, Hybrid Gold Open Access).
@article{Buscarini2014479,
title = {Italian consensus guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms},
author = {Elisabetta Buscarini and Raffaele Pezzilli and Renato Cannizzaro and Claudio De Angelis and Massimo Gion and Giovanni Morana and Giuseppe Zamboni and Paolo Arcidiacono and Gianpaolo Balzano and Luca Barresi and Daniela Basso and Paolo Bocus and Lucia Calculli and Gabriele Capurso and Vincenzo Canzonieri and Riccardo Casadei and Stefano Crippa and Mirko D'Onofrio and Luca Frulloni and Pietro Fusaroli and Guido Manfredi and Donatella Pacchioni and Claudio Pasquali and Rodolfo Rocca and Maurizio Ventrucci and Silvia Venturini and Vincenzo Villanacci and Alessandro Zerbi and Massimo Falconi and Luca Albarello and Lorenzo Camellini and Paolo Cantù and Rita Conigliaro and Guido Costamagna and Giuseppe Del Favero and Giovanna Del Vecchio Blanco and Pierluigi Di Sebastiano and Carlo Fabbri and Paolo Federici and Niccola Funel and Andrea Galli and Armando Gabbrielli and Rossella Graziani and Tiziana Guadagnini and Andrea Laghi and Giampiero Macarri and Fabrizio Magnolfi and Marco Marzioni and Fabio Monica and Nicola Muscatiello and Massimiliano Mutignani and Antonio Pisani and Enrico Scarano and Carla Serra and Marco Spada and Marco Visconti and Alessandro Zambelli},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84902543653&doi=10.1016%2fj.dld.2013.12.019&partnerID=40&md5=2c2688b654cfa4b98a85319aa8f993d1},
doi = {10.1016/j.dld.2013.12.019},
issn = {15908658},
year = {2014},
date = {2014-01-01},
urldate = {2014-01-01},
journal = {Digestive and Liver Disease},
volume = {46},
number = {6},
pages = {479 – 493},
publisher = {Elsevier B.V.},
abstract = {This report contains clinically oriented guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms in patients fit for treatment. The statements were elaborated by working groups of experts by searching and analysing the literature, and then underwent a consensus process using a modified Delphi procedure. The statements report recommendations regarding the most appropriate use and timing of various imaging techniques and of endoscopic ultrasound, the role of circulating and intracystic markers and the pathologic evaluation for the diagnosis and follow-up of cystic pancreatic neoplasms. © 2014 Editrice Gastroenterologica Italiana S.r.l.},
note = {Cited by: 86; All Open Access, Green Open Access, Hybrid Gold Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2013
Chiaro M D; Verbeke C; Salvia R; Klöppel G; Werner J; McKay C; Friess H; Manfredi R; Cutsem E V; Löhr M; Segersvärd R; Abakken L; Adham M; N. A; Arnelo U; Bruno M; Andren-Sandberg A; Cappelli C; Costamagna G; Fave G D; Esposito I; Falconi M; Ghaneh P; Gladhaug I P; Haas S; Hauge T; Izbicki J R; Lerch M; Lundell L; Lüttges J; Mayerle J; Oppong K; Pukitis A P; Rangelova E; Rosch T; Schulick R; Sufferlein T; der Merwe S W V; Zamboni G
European experts consensus statement on cystic tumours of the pancreas Journal Article
In: Digestive and Liver Disease, vol. 45, no 9, pp. 703 – 711, 2013, ISSN: 15908658, (Cited by: 332).
@article{DelChiaro2013703,
title = {European experts consensus statement on cystic tumours of the pancreas},
author = {Marco Del Chiaro and Caroline Verbeke and Roberto Salvia and Gunter Klöppel and Jens Werner and Colin McKay and Helmut Friess and Riccardo Manfredi and Eric Van Cutsem and Matthias Löhr and Ralf Segersvärd and L. Abakken and M. Adham and Albin N. and U. Arnelo and M. Bruno and A. Andren-Sandberg and C. Cappelli and G. Costamagna and G. Delle Fave and I. Esposito and M. Falconi and P. Ghaneh and I. P. Gladhaug and S. Haas and T. Hauge and J. R. Izbicki and M. Lerch and L. Lundell and J. Lüttges and J. Mayerle and K. Oppong and A. P. Pukitis and E. Rangelova and T. Rosch and R. Schulick and T. Sufferlein and S. W. Van der Merwe and G. Zamboni},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84882261462&doi=10.1016%2fj.dld.2013.01.010&partnerID=40&md5=aca47cd1c129164e4c0687bc913f83ca},
doi = {10.1016/j.dld.2013.01.010},
issn = {15908658},
year = {2013},
date = {2013-01-01},
urldate = {2013-01-01},
journal = {Digestive and Liver Disease},
volume = {45},
number = {9},
pages = {703 – 711},
publisher = {Elsevier B.V.},
abstract = {Cystic lesions of the pancreas are increasingly recognized. While some lesions show benign behaviour (serous cystic neoplasm), others have an unequivocal malignant potential (mucinous cystic neoplasm, branch- and main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm). European expert pancreatologists provide updated recommendations: diagnostic computerized tomography and/or magnetic resonance imaging are indicated in all patients with cystic lesion of the pancreas. Endoscopic ultrasound with cyst fluid analysis may be used but there is no evidence to suggest this as a routine diagnostic method. The role of pancreatoscopy remains to be established. Resection should be considered in all symptomatic lesions, in mucinous cystic neoplasm, main duct intraductal papillary mucinous neoplasm and solid pseudo-papillary neoplasm as well as in branch duct intraductal papillary mucinous neoplasm with mural nodules, dilated main pancreatic duct >6. mm and possibly if rapidly increasing in size. An oncological partial resection should be performed in main duct intraductal papillary mucinous neoplasm and in lesions with a suspicion of malignancy, otherwise organ preserving procedures may be considered. Frozen section of the transection margin in intraductal papillary mucinous neoplasm is suggested. Follow up after resection is recommended for intraductal papillary mucinous neoplasm, solid pseudo-papillary neoplasm and invasive cancer. © 2013 Editrice Gastroenterologica Italiana S.r.l.},
note = {Cited by: 332},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2012
Tanaka M; Castillo C F; Adsay V; Chari S; Falconi M; Jang J; Kimura W; Levy P; Pitman M B; Schmidt C M; Shimizu M; Wolfgang C L; Yamaguchi K; Yamao K
International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas Journal Article
In: Pancreatology, vol. 12, no 3, pp. 183 – 197, 2012, ISSN: 14243903, (Cited by: 1653).
@article{Tanaka2012183,
title = {International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas},
author = {Masao Tanaka and Carlos Fernández-Del Castillo and Volkan Adsay and Suresh Chari and Massimo Falconi and Jin-Young Jang and Wataru Kimura and Philippe Levy and Martha Bishop Pitman and C. Max Schmidt and Michio Shimizu and Christopher L. Wolfgang and Koji Yamaguchi and Kenji Yamao},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84862168016&doi=10.1016%2fj.pan.2012.04.004&partnerID=40&md5=442c2cf24cdc763459b3ab45eb535705},
doi = {10.1016/j.pan.2012.04.004},
issn = {14243903},
year = {2012},
date = {2012-01-01},
urldate = {2012-01-01},
journal = {Pancreatology},
volume = {12},
number = {3},
pages = {183 – 197},
publisher = {Elsevier B.V.},
abstract = {The international consensus guidelines for management of intraductal papillary mucinous neoplasm and mucinous cystic neoplasm of the pancreas established in 2006 have increased awareness and improved the management of these entities. During the subsequent 5 years, a considerable amount of information has been added to the literature. Based on a consensus symposium held during the 14th meeting of the International Association of Pancreatology in Fukuoka, Japan, in 2010, the working group has generated newguidelines. Since the levels of evidence for all items addressed in these guidelines are low, being 4 or 5, we still have to designate them "consensus", rather than "evidence-based", guidelines. To simplify the entire guidelines, we have adopted a statement format that differs from the 2006 guidelines, although the headings are similar to the previous guidelines, i.e., classification, investigation, indications for and methods of resection and other treatments, histological aspects, and methods of follow-up. The present guidelines include recent information and recommendations based on our current understanding, and highlight issues that remain controversial and areas where further research is required. Copyright © 2012, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd.},
note = {Cited by: 1653},
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2006
Tanaka M; Chari S; Adsay V; Castillo C F; Falconi M; Shimizu M; Yamaguchi K; Yamao K; Matsuno S
International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas Journal Article
In: Pancreatology, vol. 6, no 1-2, pp. 17 – 32, 2006, ISSN: 14243903, (Cited by: 1623).
@article{Tanaka200617,
title = {International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas},
author = {Masao Tanaka and Suresh Chari and Volkan Adsay and Carlos Fernandez-del Castillo and Massimo Falconi and Michio Shimizu and Koji Yamaguchi and Kenji Yamao and Seiki Matsuno},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-33646137556&doi=10.1159%2f000090023&partnerID=40&md5=e80ba0ff84910ad7b75ff496bada5913},
doi = {10.1159/000090023},
issn = {14243903},
year = {2006},
date = {2006-01-01},
urldate = {2006-01-01},
journal = {Pancreatology},
volume = {6},
number = {1-2},
pages = {17 – 32},
publisher = {Elsevier B.V.},
abstract = {Non-inflammatory cystic lesions of the pancreas are increasingly recognized. Two distinct entities have been defined, i.e., intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN). Ovarian-type stroma has been proposed as a requisite to distinguish MCN from IPMN. Some other distinct features to characterize IPMN and MCN have been identified, but there remain ambiguities between the two diseases. In view of the increasing frequency with which these neoplasms are being diagnosed worldwide, it would be helpful for physicians managing patients with cystic neoplasms of the pancreas to have guidelines for the diagnosis and treatment of IPMN and MCN. The proposed guidelines represent a consensus of the working group of the International Association of Pancreatology. Copyright © 2006 S. Karger AG, and IAP.},
note = {Cited by: 1623},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
