2013 Volume 28 Issue 2 Pages 163-172
To discuss the optimal excision method for intraductal papillary mucinous neoplasm of the pancreas (IPMN), it is necessary to better understand the pathology of this condition. Does the growth of IPMN occur even after infiltration? Cases of IPMN-derived invasive carcinoma have a fairly poor five-year survival rate of approximately 40%. IPMN can be curable if surgery is performed during the in situ carcinoma stage or earlier. Although unnecessary surgery should be avoided in cases where the cancer has not infiltrated and poses no threat to the life of its host, one must not allow lives to be lost to cancer because of waiting too long. Therefore, surgeons must exercise extreme caution and treat the cancer through both surgery and pre- and postoperative care and limiting mortalities due to surgical complications. In addition to the standard procedures of pancreaticoduodenectomy, pylorus-preserving pancreaticoduodenectomy and resection of the pancreatic body and tail with splenectomy, surgical procedures for IPMN includes segmental pancreatectomy, uncal resection, duodenum-preserving subtotal resection of the head of the pancreas, and spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein.
