TY - JOUR
T1 - Diagnostic significance of a dilated orifice of the duodenal papilla in intraductal papillary mucinous neoplasm of the pancreas
AU - Aso, Teppei
AU - Takao, Ohtsuka
AU - Ideno, Noboru
AU - Kono, Hiroshi
AU - Nagayoshi, Yosuke
AU - Mori, Yasuhisa
AU - Ohuchida, Kennoki
AU - Ueda, Junji
AU - Takahata, Shunnichi
AU - Morimatsu, Katsuya
AU - Aishima, Shinichi
AU - Igarashi, Hisato
AU - Ito, Tetsuhide
AU - Ishigami, Kousei
AU - Mizumoto, Kazuhiro
AU - Tanaka, Masao
PY - 2012/8
Y1 - 2012/8
N2 - Background: A dilated orifice of the duodenal papilla found during screening endoscopy or ERCP is well-known as one of the specific findings of intraductal papillary mucinous neoplasm (IPMN). However, its clinical significance is still unclear. Objective: To assess the diagnostic significance of a dilated orifice of the duodenal papilla and evaluate whether this could be a factor predictive of malignancy or a subtype of IPMN. Design: Retrospective study. Setting: University hospital. Patients: This study involved 149 patients who underwent pancreatectomy for IPMN between January 1987 and June 2011. Intervention: ERCP. Main Outcome Measurements: The rate of malignant and intestinal type IPMNs in patients with and without papillary dilation. Results: A dilated orifice of the duodenal papilla was significantly associated with intestinal type IPMN (P <.001), but this finding could not predict the malignant grade of IPMN (P =.13). Multivariate analysis revealed that a dilated orifice was a significant factor for predicting intestinal type in both main duct (P =.01) and branch duct IPMNs (P <.001). Limitations: The validity of the definition of papillary dilation, selection bias, and a retrospective study. Conclusion: A dilated orifice of the duodenal papilla could be a significant factor for predicting intestinal type IPMN. This may lead to better clinical management of patients with IPMN.
AB - Background: A dilated orifice of the duodenal papilla found during screening endoscopy or ERCP is well-known as one of the specific findings of intraductal papillary mucinous neoplasm (IPMN). However, its clinical significance is still unclear. Objective: To assess the diagnostic significance of a dilated orifice of the duodenal papilla and evaluate whether this could be a factor predictive of malignancy or a subtype of IPMN. Design: Retrospective study. Setting: University hospital. Patients: This study involved 149 patients who underwent pancreatectomy for IPMN between January 1987 and June 2011. Intervention: ERCP. Main Outcome Measurements: The rate of malignant and intestinal type IPMNs in patients with and without papillary dilation. Results: A dilated orifice of the duodenal papilla was significantly associated with intestinal type IPMN (P <.001), but this finding could not predict the malignant grade of IPMN (P =.13). Multivariate analysis revealed that a dilated orifice was a significant factor for predicting intestinal type in both main duct (P =.01) and branch duct IPMNs (P <.001). Limitations: The validity of the definition of papillary dilation, selection bias, and a retrospective study. Conclusion: A dilated orifice of the duodenal papilla could be a significant factor for predicting intestinal type IPMN. This may lead to better clinical management of patients with IPMN.
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U2 - 10.1016/j.gie.2012.03.682
DO - 10.1016/j.gie.2012.03.682
M3 - Article
C2 - 22658387
AN - SCOPUS:84864115161
SN - 0016-5107
VL - 76
SP - 313
EP - 320
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 2
ER -