Intraductal papillary mucinous neoplasms of the pancreas (IPMN)

Rapport présenté au 117e congrès de chirurgie 2015

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Publisher: ARNETTE
Pages: 160
Format: 16 x 24 cm
ISBN : 978-2-7184-1378-5
Printed in: French
Publication date: 01/10/2015

Intraductal papillary mucinous neoplasms of the pancreas (IPMN) are cyst-like tumours first identified in the early 80s and whose main characteristic is the ability to evolve into a pancreatic carcinoma.

The purpose of this report is to provide and overall vision of the treatment of IPMNs in French surgical centres.

 A new consensus conference in 2012 specified the indications for resection or monitoring in this disease. In fact, the indication for surgery is a balance between, on the one hand, the risk of IPMN progressing and, on the other hand, the risk of surgery performed on what is usually a healthy, and therefore « soft » pancreas, usually more prone to postoperative complications. Furthermore, pancreatic resection exposes the patient to the onset of diabetes. It is therefore preferable, in cases where the IPMN has not deteriorated, to give precedence to « economic » resection of the pancreatic parenchyma. For the moment, there are only retrospective publications with a single-centre or limited number of centres reporting the therapeutic strategies and their outcomes.

 

CONTENTS


• Introduction
• Epidemiology, genetic and epigenetics bases of carcinogenesis
• Impact on the risk of degeneration and prognosis
• Definition and classification
• IPMN diagnostics
• Therapeutic strategy, Indications and techniques for surgical resection
• Anatomopathology : histological classification, anatomopathological examination standards
• Differential diagnosis, predictive factors for malignancy/aggressiveness
• Monitoring and follow-up procedures (non resected patient, and after surgical resection) (SSR and overall survival)
• Associated cancers
• AFC series