Clinical Challenges in Hepatobiliary Surgery: Intraductal Papillary Mucinous Neoplasm (IPMN)

What’s the one clinical scenario where you can really save a patient’s life with a pancreatectomy? An IPMN with high-grade dysplasia! Join the Behind the Knife HPB Team for a deep dive into the complex decision-making surgical management of IPMNs.

Learning Objectives

In this episode, we review the basics of intraductal papillary mucinous neoplasms, how to evaluate patients with a cystic mass of the pancreas, guidelines for surveillance, and indications for resection. We discuss key concepts such as Worrisome Features and High-Risk Stigmata and how those influence surgical decision-making, and tackle a few of the most challenging scenarios surgeons may face when treating patients with IPMNs.

 

Hosts:

Timothy Vreelant, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center

Daniel Nelson, DO, FACS (@DWNelsonHPB) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center

Connor Chick, MD (@connor_chick) is a PGY-6 General Surgery resident at Brooke Army Medical Center

Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-5 General Surgery resident at Brooke Army Medical Center

Beth Carpenter, MD (@elizcarpenter16) is a PGY-4 General Surgery resident at Brooke Army Medical Center



Links to Papers Referenced in this Episode

Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas

Pancreatology. 2017 Sep-Oct;17(5):738-753.

https://pubmed.ncbi.nlm.nih.gov/28735806/

Number of Worrisome Features and Risk of Malignancy in Intraductal Papillary Mucinous Neoplasm. 

J Am Coll Surg. 2022 Jun 1;234(6):1021-1030. 

https://pubmed.ncbi.nlm.nih.gov/35703792/

Extent of Surgery and Implications of Transection Margin Status after Resection of IPMNs. 

Gastroenterology Research and Practice 2014, 1–10.

https://pubmed.ncbi.nlm.nih.gov/25276122/



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