Author Affiliations: Department of Surgery, The Johns Hopkins Medicine, Suburban Hospital, Bethesda, Maryland.
The more data accumulate on intraductal papillary mucinous neoplasms (IPMNs), the more we see that its treatment is a balancing act. Are all IPMNs premalignant? Should all diseases be resected? Can we leave positive margins? How often should we follow-up with patients postoperatively?
Moriya and Traverso1 show that this “field defect” in pancreatic genetics should be handled by experts. A cohort of 203 patients underwent partial pancreatic resection by a surgeon who tailored operations using current theory and who leads a very effective multidisciplinary group. Postoperatively, patients were cautiously observed for 40 months. Only from a model like this can we learn about IPMNs.
Zenilman ME. The Balance: Comment on “Fate of the Pancreatic Remnant After Resection for an Intraductal Papillary Mucinous Neoplasm”. Arch Surg. 2012;147(6):534–535. doi:10.1001/archsurg.2012.452
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