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 ObjectivesIn 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 CenterDaniel 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 CenterConnor Chick, MD (@connor_chick) is a PGY-6 General Surgery resident at Brooke Army Medical CenterLexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-5 General Surgery resident at Brooke Army Medical CenterBeth Carpenter, MD (@elizcarpenter16) is a PGY-4 General Surgery resident at Brooke Army Medical CenterLinks to Papers Referenced in this EpisodeRevisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreasPancreatology. 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/Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out other Hepatobiliary Surgery episodes here: https://behindtheknife.org/podcast-category/hepatobiliary/