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.
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.
Authors: Thiruvengadam Muniraj; Harry R Aslanian; Loren Laine; Priya A Jamidar; James F Farrell; Kisha A Mitchell; Ronald R Salem Journal: World J Gastroenterol Date: 2021-04-21 Impact factor: 5.742