Table 2 Indications for surgery, surgery type and complications, and pathology analysis results of the surgically removed IPMN
Variables | All resection types N = 124 N (%) | Whipple procedure and total pancreatectomy N = 75 N (%) | Distal pancreatectomy N = 45 N (%) | p Fisher exact test |
|---|---|---|---|---|
Indication for surgery | ||||
Symptoms | 42 (34): | 30 (40): | 12 (27) | 0,1 |
Acute pancreatitis N = 26 | Acute pancreatitis N = 14 | Acute pancreatitis N = 12 | ||
Jaundice N = 8 | Jaundice N = 8 | Jaundice N = 0 | ||
Imaging features | Pain and/or new onset of diabetes N = 8 | Pain and/or new onset of diabetes N = 8 | Pain and/or new onset of diabetes N = 0 | |
(From Sendai and Fukuoka consensus) Progression criteria | 65 (53) | 37 (49.5) | 24 (53) | 0.7 |
(Growth of 5 mm/year or increase in size of main pancreatic duct)(*) | 17 (13) | 8 (11) | 9 (20) | 0.1 |
Procedures | ||||
Pancreatoduodenectomy | 56 (45) | |||
Distal pancreatectomy | 45 (36) | |||
Enucleation | 3 (2.5) | |||
Total pancreatectomy | 19 (15) | |||
Central pancreatectomy | 1 (0.5) | |||
Post-operative complications | ||||
Biochemical leak | 39 (31) | 15 (27) | 20 (44) | |
Grade B pancreatic fistula | 6 (5) | 5 (9) | 1 (2) | |
Grade C pancreatic fistula | 5 (2.5) | 5 (9) | 0 | |
Post-operative haemorrhage (**) | 6 (5) | 4 (5.5) | 2 (4) | |
Dindo-Clavien III-IV | 15 (12) | 14 (18) | 1 (2) | |
Dindo-Clavien V | 4 (3) | 3 (4) | 1 (2) | |
Overall morbidity (***) | 36 (29) | 31 (41) | 5 (12) | 0.0001 |
Pathology: Macroscopic | ||||
Branch duct | 33 (26.5) | 23 (31) | 6 (13) | |
Main duct | 46 (37) | 27 (36) | 19 (43) | 0.01 |
Mixed | 45 (36.5) | 25 (34) | 20 (44) | (Branch duct vs Main duct and mixed) |
Pathology: Microscopic | ||||
Low grade dysplasia | 51 (41) | 20 (26) | 28 (62) | |
Intermediate dysplasia | 11 (9) | 9 (12) | 0 | |
High grade dysplasia | 25 (20) | 18 (24) | 7 (14) | 0.01 |
Invasive carcinoma (****) | 37 (30) | 28 (38) | 9 (20) | (Low and intermediate dysplasia vs high grade dysplasia/invasive carcinoma) |
Pathology: Subtyping | ||||
Gastric | 15 (12.5) | 6 (8) | 9 (20) | |
Intestinal | 34 (27) | 26 (35) | 8 (18) | |
Hepatobiliary | 56 (45) | 32 (43) | 21 (47) | |
Oncocytic | 5 (4) | 3 (4) | 1 (2) | |
Other | 14 (11.5) | 8 (11) | 6 (13) | |