Management of intraductal papillary and mucinous pancreatic neoplasms

Abstract

Management of intraductal papillary and mucinous pancreatic neoplasms. Mucinous and papillary pancreatic cystic neoplasm is a controversial pathology both from a diagnostic point of view and from a management point of view. These recommendations will include diagnostic modalities and criteria (endoscopic, imaging and histopathological), conservative management of cystic pancreatic, mucinous and papillary neoplasm and its absolute and relative surgical indications. High risk factors (high risk stigmata) for which surgery is indicated without further exploration are positive cytology for malignancy, jaundice, dilation of the main pancreatic duct over 10 mm in diameter and the presence of the wall nodule over 5 mm. For patients with a diameter of the main pancreatic duct between 5 and 9.9 mm or a cyst larger than 4 cm, surgery has a relative indication, and for asymptomatic patients with a cyst smaller than 4 cm without parietal nodules, a Conservative management is more appropriate.Our goal is to develop a protocol based on the new European recommendations published by the European Study Group on Cystic Pancreatic Tumors, in order to facilitate the early diagnosis and treatment of patients. We also want to sensitize the specialists and make them aware of the need to develop centers dedicated to hepato-biliary-pancreatic pathology and to improve the logistical means.