The management of branch duct IPMNs is more complicated than is the management of main duct type IPMNs. It is likely that many, if not most, branch duct IPMNs are harmless and the risks associated with surgery may outweigh the benefits of resecting small branch duct IPMNs. International consensus guidelines for the treatment of branch duct IPMNs were established in 2006.
These guidelines try to balance the risks and benefits of treating patients with a branch duct type IPMN (see reference 5). The guidelines suggest that asymptomatic patients with a branch duct IPMN that a) is less than 3 cm in size, b) not associated with dilatation (ballooning) of the main pancreatic duct, and c) does not contain a solid mass (mural nodule), can be followed safely without surgery. By contrast, the guidelines recommend the surgical resection of branch duct type IPMNs that cause symptoms, that are larger than 3 cm, that contain a mass (mural nodule), OR which are associated with dilatation of the main ... more.
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