Table 3

Absolute and relative indications for surgery in IPMN

Absolute indicationsRelative indications
Positive cytology for malignancy/HGDGrow-rate ≥5 mm/year
Solid massIncreased levels of serum CA 19.9 (>37 U/mL)*
Jaundice (tumour related)MPD dilatation between 5 and 9.9 mm
Enhancing mural nodule (≥5 mm)Cyst diameter ≥40 mm
MPD dilatation ≥10 mmNew onset of diabetes mellitus
Acute pancreatitis (caused by IPMN)
Enhancing mural nodule (<5 mm)
  • *In the absence of jaundice.

  • HGD, high-grade dysplasia; IPMN, intraductal papillary mucinous neoplasm; MPD, main pancreatic duct.