Endoscopic Management and Follow-Up of Intraductal Papillary Mucinous Neoplasia (IPMN)

Abstract

Intraductal papillary mucinous neoplasms (IPMN) are common and increasingly detected in patients undergoing cross-sectional imaging for reasons unrelated to the pancreas. Individuals diagnosed with an IPMN should be followed over time because of the malignant potential of these cystic lesions. The primary goal of surveillance is to identify the small minority of IPMN that progresses into advanced neoplasia and benefits from resection, while simultaneously avoiding unnecessary pancreatic surgery in the majority of IPMN that remains benign. Cross-sectional imaging and endoscopic ultrasound with or without fluid and tissue acquisition are currently used to evaluate the risk of malignancy in IPMN. This chapter summarizes the diagnostic workup, surveillance, and treatment of IPMN, focusing on endoscopic modalities and adjacent tests.