Surgical Aspects of Intraductal Papillary Mucinous Neoplasms of the Pancreas

Intraductal papillary mucinous neoplasms (IPMN) play an important role mongst exocrine tumours of the pancreas due to several causes. Although they count for only 1% of all the tumours, they represent some 20-30% of all cystic neoplasms, a histologically defined group that has gained a lot of attention lately. IPMNs of the main or the secondary (branch) pancreatic ducts have remarkably different rates of malignant transformation, prognosis and thus indication for surgery. Prognosis of a ductal carcinoma developing from IPMN does not differ from classic ductal adenocarcinoma, with a very poor (10%) 5-year survival rate. However, prognosis of IPMN can still be regarded favourable, because the above rate can be as high as 70% if the tumour is non-invasive. This fact leads to the importance of diagnosing and resecting IPMN before its malignant transformation into an invasive carcinoma.