Branch Duct IPMN-Associated Acute Pancreatitis in a Large Single-Center Cohort Study

<b>Background/Objectives</b>: IPMNs are a possible cause of acute pancreatitis (AP). IPMN-associated-AP is considered a relative indication for surgery for the prevention of recurrent attacks of pancreatitis and for a hypothesized increased cancer risk. The literature is based on surgica...

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Main Authors: Nicolò de Pretis, Luigi Martinelli, Antonio Amodio, Federico Caldart, Salvatore Crucillà, Maria Sole Battan, Alberto Zorzi, Stefano Francesco Crinò, Maria Cristina Conti Bellocchi, Laura Bernardoni, Giulia De Marchi, Pietro Campagnola, Roberto Salvia, Armando Gabbrielli, Alessandro Marcon, Luca Frulloni
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/13/1676
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author Nicolò de Pretis
Luigi Martinelli
Antonio Amodio
Federico Caldart
Salvatore Crucillà
Maria Sole Battan
Alberto Zorzi
Stefano Francesco Crinò
Maria Cristina Conti Bellocchi
Laura Bernardoni
Giulia De Marchi
Pietro Campagnola
Roberto Salvia
Armando Gabbrielli
Alessandro Marcon
Luca Frulloni
author_facet Nicolò de Pretis
Luigi Martinelli
Antonio Amodio
Federico Caldart
Salvatore Crucillà
Maria Sole Battan
Alberto Zorzi
Stefano Francesco Crinò
Maria Cristina Conti Bellocchi
Laura Bernardoni
Giulia De Marchi
Pietro Campagnola
Roberto Salvia
Armando Gabbrielli
Alessandro Marcon
Luca Frulloni
author_sort Nicolò de Pretis
collection DOAJ
description <b>Background/Objectives</b>: IPMNs are a possible cause of acute pancreatitis (AP). IPMN-associated-AP is considered a relative indication for surgery for the prevention of recurrent attacks of pancreatitis and for a hypothesized increased cancer risk. The literature is based on surgical series, and no data on the clinical features of AP associated with IPMNs and on the risk of recurrent pancreatitis and pancreatic cancer are available. This study aimed to describe the clinical/radiological features of BD-IPMN-associated AP. Moreover, BD-IPMN-associated risk factors for AP recurrence and risk of pancreatic cancer were investigated. <b>Methods</b>: Patients with AP associated with branch-duct IPMN (BD-IPMN) without “worrisome- features” and “high-risk-stigmata” evaluated in a Gastroenterology Unit (University of Verona) between 1 January 2012 and 31 December 2022 were retrospectively analyzed. Cox proportional hazard models were used to analyze the time to recurrence after the first occurrence of AP. <b>Results</b>: One hundred and thirty-five patients were included, with a mean age of 55.8 ± 12.5 years. Necrosis was diagnosed in 15 patients (11.1%) and 1 patient (0.7%) was admitted to the ICU. One hundred and two (75.6%) patients had recurrent pancreatitis. The median size of the largest BD-IPMN was 8 mm (Q1–Q3: 5–12). Eighteen patients (13.3%) developed main pancreatic duct dilation ≥ 5 mm. No patients developed dilation of the main pancreatic duct ≥ 10 mm, mural nodules, thickened cystic walls, or jaundice. In the unadjusted analysis, no BD-IPMN-related features were associated with an increased risk of recurrent pancreatitis. None of the patients developed pancreatic cancer. <b>Conclusions</b>: BD-IPMN-associated AP appears to have a benign clinical course. Cystic features related to increased risk of recurrence were not identified. The risk of cancer appears extremely low.
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spelling doaj-art-3963f074dd5b42d6955d8fd0eb7e54b22025-08-20T03:16:47ZengMDPI AGDiagnostics2075-44182025-07-011513167610.3390/diagnostics15131676Branch Duct IPMN-Associated Acute Pancreatitis in a Large Single-Center Cohort StudyNicolò de Pretis0Luigi Martinelli1Antonio Amodio2Federico Caldart3Salvatore Crucillà4Maria Sole Battan5Alberto Zorzi6Stefano Francesco Crinò7Maria Cristina Conti Bellocchi8Laura Bernardoni9Giulia De Marchi10Pietro Campagnola11Roberto Salvia12Armando Gabbrielli13Alessandro Marcon14Luca Frulloni15Gastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyDepartment of Diagnostics and Public Health, University of Verona, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, ItalyDepartment of Surgery, University of Verona, 37134 Verona, ItalyGastroenterology Unit, University of Trento, 38122 Trento, ItalyDepartment of Diagnostics and Public Health, University of Verona, 37134 Verona, ItalyGastroenterology Unit, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy<b>Background/Objectives</b>: IPMNs are a possible cause of acute pancreatitis (AP). IPMN-associated-AP is considered a relative indication for surgery for the prevention of recurrent attacks of pancreatitis and for a hypothesized increased cancer risk. The literature is based on surgical series, and no data on the clinical features of AP associated with IPMNs and on the risk of recurrent pancreatitis and pancreatic cancer are available. This study aimed to describe the clinical/radiological features of BD-IPMN-associated AP. Moreover, BD-IPMN-associated risk factors for AP recurrence and risk of pancreatic cancer were investigated. <b>Methods</b>: Patients with AP associated with branch-duct IPMN (BD-IPMN) without “worrisome- features” and “high-risk-stigmata” evaluated in a Gastroenterology Unit (University of Verona) between 1 January 2012 and 31 December 2022 were retrospectively analyzed. Cox proportional hazard models were used to analyze the time to recurrence after the first occurrence of AP. <b>Results</b>: One hundred and thirty-five patients were included, with a mean age of 55.8 ± 12.5 years. Necrosis was diagnosed in 15 patients (11.1%) and 1 patient (0.7%) was admitted to the ICU. One hundred and two (75.6%) patients had recurrent pancreatitis. The median size of the largest BD-IPMN was 8 mm (Q1–Q3: 5–12). Eighteen patients (13.3%) developed main pancreatic duct dilation ≥ 5 mm. No patients developed dilation of the main pancreatic duct ≥ 10 mm, mural nodules, thickened cystic walls, or jaundice. In the unadjusted analysis, no BD-IPMN-related features were associated with an increased risk of recurrent pancreatitis. None of the patients developed pancreatic cancer. <b>Conclusions</b>: BD-IPMN-associated AP appears to have a benign clinical course. Cystic features related to increased risk of recurrence were not identified. The risk of cancer appears extremely low.https://www.mdpi.com/2075-4418/15/13/1676IPMNacute pancreatitispancreatitiscancerrecurrent pancreatitisrelapse
spellingShingle Nicolò de Pretis
Luigi Martinelli
Antonio Amodio
Federico Caldart
Salvatore Crucillà
Maria Sole Battan
Alberto Zorzi
Stefano Francesco Crinò
Maria Cristina Conti Bellocchi
Laura Bernardoni
Giulia De Marchi
Pietro Campagnola
Roberto Salvia
Armando Gabbrielli
Alessandro Marcon
Luca Frulloni
Branch Duct IPMN-Associated Acute Pancreatitis in a Large Single-Center Cohort Study
Diagnostics
IPMN
acute pancreatitis
pancreatitis
cancer
recurrent pancreatitis
relapse
title Branch Duct IPMN-Associated Acute Pancreatitis in a Large Single-Center Cohort Study
title_full Branch Duct IPMN-Associated Acute Pancreatitis in a Large Single-Center Cohort Study
title_fullStr Branch Duct IPMN-Associated Acute Pancreatitis in a Large Single-Center Cohort Study
title_full_unstemmed Branch Duct IPMN-Associated Acute Pancreatitis in a Large Single-Center Cohort Study
title_short Branch Duct IPMN-Associated Acute Pancreatitis in a Large Single-Center Cohort Study
title_sort branch duct ipmn associated acute pancreatitis in a large single center cohort study
topic IPMN
acute pancreatitis
pancreatitis
cancer
recurrent pancreatitis
relapse
url https://www.mdpi.com/2075-4418/15/13/1676
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