Absolute and relative indications for surgery in IPMN
| Absolute indications | Relative indications |
| Positive cytology for malignancy/HGD | Grow-rate ≥5 mm/year |
| Solid mass | Increased 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 mm | New 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.