Branch Duct IPMN-Associated Acute Pancreatitis in a Large Single-Center Cohort Study.

Area of Science:

• Gastroenterology
• Oncology
• Pancreatology

Background:

• Intraductal papillary mucinous neoplasms (IPMNs) are recognized causes of acute pancreatitis (AP).
• IPMN-associated AP often prompts surgical consideration due to recurrent pancreatitis risk and potential cancer development.
• Limited data exists on the clinical course and long-term outcomes of AP specifically linked to branch-duct IPMNs (BD-IPMNs).

Purpose of the Study:

• To delineate the clinical and radiological characteristics of AP associated with BD-IPMN.
• To identify BD-IPMN-related risk factors for recurrent AP.
• To assess the risk of pancreatic cancer in patients with BD-IPMN-associated AP.

Main Methods:

• Retrospective analysis of 135 patients with BD-IPMN-associated AP without "worrisome features" or "high-risk stigmata" from 2012-2022.
• Evaluation of clinical and radiological data, including IPMN size and main pancreatic duct (MPD) diameter.
• Cox proportional hazard models were employed to analyze recurrence risk.

Main Results:

• The majority of patients (75.6%) experienced recurrent pancreatitis.
• No significant association was found between BD-IPMN features (e.g., size, MPD dilation <5mm) and recurrent pancreatitis risk.
• No pancreatic cancer developed during the study period; no high-risk IPMN features like mural nodules or jaundice were observed.

Conclusions:

• Acute pancreatitis associated with BD-IPMN, particularly those without high-risk stigmata, appears to follow a generally benign clinical course.
• Specific cystic features within BD-IPMNs were not identified as predictors of recurrent pancreatitis in this cohort.
• The risk of pancreatic cancer in this specific patient group seems exceptionally low.