BACKGROUND AND AIM: It has been reported that main duct @entity4929 are more invasive and have a worse prognosis than branch duct @entity4929 . Therefore, an aggressive surgical approach has mainly been recommended for all MD-IPMNs. However, the surgical management of BD-IPMNs has been controversial and the consensus guidelines are not specific for an indicator of @entity5 in BD-IPMNs. The objective of this study was to determine the proper management and follow-up strategy of BD-IPMNs. METHODS: We monitored and analysed @entity1 with presumed BD-IPMNs between March 1995 and March 2010. RESULT: The mean value of the initial cyst size in all @entity1 with BD-IPMNs was 2.19 cm. Amongst 194 @entity1 with BD-IPMNs, 34 underwent immediate surgical resection, 152 were followed conservatively. Amongst the 152 conservatively managed @entity1 , 18 (11.8%) underwent surgical resection after a median follow-up of 12.7 months (range, 3-48 months). In 132 @entity1 who were managed conservatively without surgery, the mean incremental rate of cyst size growth was 0.0038 cm/month during a median of 30.7 months of follow-up and there were no IPMN-related @entity204 . CONCLUSION: Amongst @entity1 with BD-IPMNs, about 10% have surgery within approximately 1 year from the time of diagnosis because of the occurrence of new malignant stigmata. Therefore, a conservative approach without surgery and careful follow-up every 3 months or 6 months during the first year after diagnosis can be safely advocated in @entity1 with BD-IPMNs larger than 10mm in size who have no risk factors for malignant IPMNs.

Proper management and follow-up strategy of branch duct XXXX of the pancreas.

@entity5 :: ('MESH:D009369', 'Disease') :: ['malignancy'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity4929 :: ('MESH:C565310', 'Disease') :: ['intraductal papillary mucinous neoplasms'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths']
@entity4929 :: (MESH:C565310,Disease) :: ['intraductal papillary mucinous neoplasms']
