Long-term clinical and imaging follow-up of nonoperated branch duct form of intraductal papillary mucinous neoplasms of the pancreas

Pancreas. 2012 Mar;41(2):295-301. doi: 10.1097/MPA.0b013e3182285cc8.


Objectives: The aim of our study was to perform a 10-year imaging and clinical prospective follow-up of patients with nonoperated branch duct (BD) intraductal papillary mucinous neoplasms (IPMNs) of the pancreas.

Methods: Forty-nine patients with BD-IPMN who displayed a low probability for malignancy were followed up including a clinical component and a series of imaging techniques such as computed tomography, magnetic resonance cholangiopancreatography, and endoscopic ultrasonography.

Results: After a mean follow-up period of 77 months, 77.5% of patients remained free of symptoms. An increase in the size and number of BD cysts without mural nodules and with no significant increase of main duct size occurred in 18 patients at an average interval of 47 months. Five patients were operated on owing to recurrent pancreatitis and/or an increase in the size of either cysts or the main duct (mean time delay after diagnosis: 20 months). Pathologically, they were diagnosed as benign adenoma (n = 1) or borderline (n = 4).

Conclusions: Our long-term clinical and imaging follow-up indicated that none of the patients with BD-IPMNs developed malignancy. Therefore, BD-IPMNs with no signs of malignancy should be managed conservatively. We propose that following a 2-year patient follow-up, biannual imaging follow-ups could be sufficient.

MeSH terms

  • Adenoma / classification
  • Adenoma / diagnosis*
  • Adenoma / therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Pancreatic Ductal / classification
  • Carcinoma, Pancreatic Ductal / diagnosis*
  • Carcinoma, Pancreatic Ductal / therapy
  • Chi-Square Distribution
  • Cholangiopancreatography, Magnetic Resonance
  • Diagnostic Imaging* / methods
  • Disease Progression
  • Endosonography
  • Female
  • Follow-Up Studies
  • France
  • Humans
  • Male
  • Middle Aged
  • Neoplasms, Cystic, Mucinous, and Serous / classification
  • Neoplasms, Cystic, Mucinous, and Serous / diagnosis*
  • Neoplasms, Cystic, Mucinous, and Serous / therapy
  • Pancreatic Ducts* / diagnostic imaging
  • Pancreatic Ducts* / pathology
  • Pancreatic Neoplasms / classification
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / therapy
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Time Factors
  • Tomography, X-Ray Computed