Why prune an elusive branch?

摘要

For marly clinicians, the acronym IPMN could very well mean "in the pancreas, much not known," because uncertainty surrounds intraductal papillary mutinous neoplasm (IPMN) with regard to the accurate differentiation from other cystic lesions of the pancreas, the exclusion of invasive cancer, and its natural history. Ciinicians feel uneasy when deciding on the wide range of management options (ie, watchful waiting, surgical referral, or performance of another diagnostic test), with profound implications to patient outcome. Many patients with IPMN are referred to specialized pancreaticobiliary teams that consist of interventional endoscopists, radiologists, and pancreatic surgeons. Although it represents only about a third of all cystic lesions of the pancreas, IPMN has grown to become one of the most common indications for pancreatic resection in tertiary medical centers.2'3 Indeed, the number of original articles devoted to IPMN has increased steadily in the past 10 years.