Current best practice and controversies in the follow up of patients with asymptomatic branch duct IPMN of the pancreas.

Since very little high-level evidence exists in the management of intraductal papillary mucinous neoplasm (IPMN) of the pancreas, all guidelines currently available are based on expert consensus. Nonetheless, the international consensus guidelines issued in 2006 by the International Association of Pancreatology (Sendai guidelines)1 and revised in 2012 (Fukuoka guidelines) are well accepted worldwide and widely utilized in the clinical practice.2, 3, 4, 5 Few controversies remain regarding the management of main duct IPMN (MD-IPMN) given the high rate of underlying malignancy. However, for branch duct IPMN (BD-IPMN), surgical indications remain a topic of debate, since the average rate of malignancy is only 26% in such cases resected.6, 7