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.