Intraductal papillary mucinous neoplasms.

Intraductal papillary mucinous neoplasm (IPMN) is characterized by enhanced mucus secretion. It is a benign or low-grade neoplasm associated with a dilated main pancreatic duct, patulous ampullary orifice, and abundant mucus secretion. Foci of aggressive cancer may arise and become invasive. Surgery is the only treatment that can cure IPMN, but the extent of pancreatic resection and the intraoperative margins remain areas of controversy. The risks of total pancreatectomy must be weighed against the risk for developing cancer in the residual pancreas. Risks must be factored against the natural course of the disease and the likelihood of malignancy developing over the life expectancy.