Clinical Challenges in Hepatobiliary Surgery: Intraductal Papillary Mucinous Neoplasm (IPMN)

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 17 October 2022

⏱️ 45 minutes

🔗️ Recording | iTunes | RSS

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Summary

What’s the one clinical scenario where you can really save a patient’s life with a pancreatectomy? An IPMN with high-grade dysplasia! Join the Behind the Knife HPB Team for a deep dive into the complex decision-making surgical management of IPMNs.

Learning Objectives
In this episode, we review the basics of intraductal papillary mucinous neoplasms, how to evaluate patients with a cystic mass of the pancreas, guidelines for surveillance, and indications for resection. We discuss key concepts such as Worrisome Features and High-Risk Stigmata and how those influence surgical decision-making, and tackle a few of the most challenging scenarios surgeons may face when treating patients with IPMNs.

Hosts:
Timothy Vreelant, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center
Daniel Nelson, DO, FACS (@DWNelsonHPB) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center
Connor Chick, MD (@connor_chick) is a PGY-6 General Surgery resident at Brooke Army Medical Center
Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-5 General Surgery resident at Brooke Army Medical Center
Beth Carpenter, MD (@elizcarpenter16) is a PGY-4 General Surgery resident at Brooke Army Medical Center

Links to Papers Referenced in this Episode
Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas
Pancreatology. 2017 Sep-Oct;17(5):738-753.
https://pubmed.ncbi.nlm.nih.gov/28735806/
Number of Worrisome Features and Risk of Malignancy in Intraductal Papillary Mucinous Neoplasm.
J Am Coll Surg. 2022 Jun 1;234(6):1021-1030.
https://pubmed.ncbi.nlm.nih.gov/35703792/
Extent of Surgery and Implications of Transection Margin Status after Resection of IPMNs.
Gastroenterology Research and Practice 2014, 1–10.
https://pubmed.ncbi.nlm.nih.gov/25276122/

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If you liked this episode, check out other Hepatobiliary Surgery episodes here: https://behindtheknife.org/podcast-category/hepatobiliary/

Transcript

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0:35.8	Behind the knife, the surgery podcast.
0:38.9	Relevant and engaging content to sign to help you,
0:42.0	dominate the day.
0:50.1	Hi everyone and welcome back to another HPB episode of Behind the Knife.
0:56.7	Wear your HPB team with Dr. Dan Nelson from William Beaumont and El Paso,
1:00.9	and Dr. Freeland from Brook Army Medical Center in San Antonio,
1:04.1	accompanied by Residence Conor Check,
1:05.9	Lexi Adams, and myself Elizabeth Carpenter.
1:08.8	Today we're going to be tackling a challenging and somewhat controversial topic
1:12.2	in HPB surgery, Introductal Papillary Musinous Neoplasms, or IPMNs.
1:17.2	We'll focus on this topic for the next two episodes,
	...

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