BACKGROUND: Pancreatitis and jaundice secondary to ductal obstruction are c
ommon in intraductal papillary mucinous tumors (IPMT) of the pancreas. Howe
ver, the incidence and severity of the complications of obstruction are not
well documented. The aim of the study was to investigate the clinical pres
entation and outcome of 10 patients with IPMT.
METHODS: All cases of IPMT diagnosed between 1994 and 1999 were reviewed.
RESULTS: Four of the 10 patients developed severe acute illness with system
ic complications resulting from ductal obstruction. Three suffered acute ch
olangitis with sepsis, and 1 developed necrotizing pancreatitis and ARDS. T
here was 1 postoperative death in a patient with adenocarcinoma. All other
patients are alive and well with a median follow-up of 26 months (survival
90%).
CONCLUSIONS: Pancreatic or common bile duct obstruction in IPMT may result
in acute, life-threatening disease. Aggressive surgical therapy is warrante
d before development of complications of ductal obstruction or progression
of tumor occurs. (C) 2000 by Excerpta Medica, Inc.