Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas
Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas
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DOI：
10.1016/j.pan.2017.07.007
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发表时间：
2017-09-01
期刊：
影响因子：
3.6
通讯作者：
Wolfgang, Christopher L.
中科院分区：
文献类型：
--
作者：
Tanaka, Masao;Fernandez-del Castillo, Carlos;Wolfgang, Christopher L.
导管内乳头状黏液性肿瘤的治疗仍在不断发展。特别是，分支导管IPMN切除的适应症已从早期切除变为2006年和2012年国际共识指南提出的更谨慎的观察。2015年美国胃肠病学会提出的另一项指南更严格地限制了手术适应症，并建议医生在监测5年后胰腺囊肿没有发生显著变化，或者患者接受切除术后发现非恶性IPMN时停止监测，无论这样做是否安全，以及监测的方法和间隔时间，引发了激烈的争论根据2016年在日本仙台举行的国际胰腺病学协会会议期间举行的共识研讨会，工作组修订了关于侵袭性癌和高度异型增生预测，监测和IPMN术后随访的指南。由于工作小组不认为有需要对准则作出重大修订，我们只作了轻微修订，并在适当情况下加入了最新的条款。本指南包括根据我们目前的理解提供的最新信息和建议，并强调了仍有争议或需要进一步研究的问题。(C)2017年EPC和EPC。Elsevier B.V.出版，保留所有权利。
The management of intraductal papillary mucinous neoplasm (IPMN) continues to evolve. In particular, the indications for resection of branch duct IPMN have changed from early resection to more deliberate observation as proposed by the international consensus guidelines of 2006 and 2012. Another guideline proposed by the American Gastroenterological Association in 2015 restricted indications for surgery more stringently and recommended physicians to stop surveillance if no significant change had occurred in a pancreatic cyst after five years of surveillance, or if a patient underwent resection and a non-malignant IPMN was found. Whether or not it is safe to do so, as well as the method and interval of surveillance, has generated substantial debate. Based on a consensus symposium held during the meeting of the International Association of Pancreatology in Sendai, Japan, in 2016, the working group has revised the guidelines regarding prediction of invasive carcinoma and high-grade dysplasia, surveillance, and postoperative follow-up of IPMN. As the working group did not recognize the need for major revisions of the guidelines, we made only minor revisions and added most recent articles where appropriate. The present guidelines include updated information and recommendations based on our current understanding, and highlight issues that remain controversial or where further research is required. (C) 2017 LAP and EPC. Published by Elsevier B.V. All rights reserved.