Objective: To focus attention on the management and outcome of patients wit
h intraductal papillary mucinous tumours of the pancreas.
Design: Retrospective study and analysis of published reports.
Setting: University hospital, France.
Subjects: 111 patients (101 published cases and our own 10 cases) divided i
n two groups: the first including malignant tumours (n = 46), and the secon
d group benign or in situ tumours (n = 61). In 4 patients the type of tumou
r was not known.
Main outcome measure: Resectability, mortality and recurrence.
Results: More men had benign or in situ tumours [48/61 (79%) compared with
28/46 (61%), p = 0.054]. Pancreatitis was more common among benign than mal
ignant tumours [34/61 (58%) compared with 21/46 (46%), p = 0.33]. In group
I, 39 patients had diabetes. A total of 107 patients were operated on: panc
reaticoduodenectomy (n = 54, 50%), distal pancreatectomy (n = 25, 23%), tot
al pancreatectomy (n = 4, 4%), bypass (n = 2, 2%). The type of resection wa
s not mentioned in 22 records (21%). Four patients were not operated on bec
ause of their poor general condition. The resectability rate was 98% (105/1
07). Eleven patients had died at the time of publication. Hospital mortalit
y rate was 3% (n = 3), mainly because 2 of the 4 who had total pancreatecto
my died. With a median follow-up of 37 months, recurrence was 5% (n = 5).
Conclusion: Intraductal papillary mucinous tumours of the pancreas are well
known distinctive pancreatic tumours that are usually intraductal but may
develop into invasive, carcinoma. They should be resected, and have a good
prognosis and low recurrence rate.