Skip to main content

Table 2 Indications for surgery, surgery type and complications, and pathology analysis results of the surgically removed IPMN

From: Intraductal papillary mucinous neoplasms of the pancreas and European guidelines: importance of the surgery type in the decision-making process

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)  
  1. * Follow up included clinical and CT scan evaluations at least every 6 months (median follow-up 12 month (range 6–17)
  2. **: Grade A n = 2, Grade B n = 2, Grade C n = 2
  3. ***: Overall morbidity includes Grade B and C fistula, post-operative haemorrhage and Dindo-Clavien grade III-IV-V complication
  4. ***: Well-differentiated n = 16 (43%); moderately differentiated n = 18 (48%); poorly differentiated n = 3 (9%)