Management of branch-duct IPMN

IPMN: intraductal pancreatic mucinous neoplasm; MRCP: magnetic resonance cholangiopancreatography; CT: computed tomography; EUS: endoscopic ultrasound; FNA: fine-needle aspiration.
* For patients with multiple cysts, each lesion is managed as it would be if it were the only lesion. Published guidelines on the management of pancreatic cystic neoplasms are variable. This algorithm reflects the authors' approach, which is largely consistent with published guidelines. Refer to UpToDate topic reviews on IPMN management for additional details.
¶ The decision to recommend surgery should take into account factors such as the patient's age and general health, the malignant risk of the specific lesion, and the suspicion for malignancy.
Δ Surveillance recommendations will depend on the size of the cyst, whether the patient is a good surgical candidate, and whether the cyst is stable on repeat imaging. Refer to UpToDate topics on the management of IPMN for details.