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Invited Commentary
May 19, 2021

Management of Intraductal Papillary Mucinous Neoplasms—Watch and Wait or Operate?

Author Affiliations
  • 1Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California
JAMA Surg. 2021;156(9):825-826. doi:10.1001/jamasurg.2021.0951

High-resolution abdominal imaging and rising life expectancy have contributed to the increasing recognition of pancreatic cystic disease. Intraductal papillary mucinous neoplasms (IPMNs) are a potential precursor lesion for invasive carcinoma and are most commonly surveyed because of the low risk of malignant transformation and high risks of major surgery.1 International Association of Pancreatology guidelines recommend close surveillance of IPMNs, unless criteria for size (≥3 cm), high-risk stigmata (eg, obstructive jaundice, elevated CA 19-9 levels), or worrisome features (eg, a main pancreatic duct >5 mm, mural nodule, wall thickening, growth rate >5 mm in 2 years) are fulfilled.2 Other societies, including the American College of Gastroenterology, American Gastroenterological Association, and American College of Radiology offer similar key recommendations for the management of IPMNs.3

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