Intraductal Papillary Mucinous Tumors of the Pancreas. Surgical Treatment: At What Point Should We Stop?

The intraoperative management of the margins of intraductal papillary mucinous tumors (IPMNs) undergoing pancreatic resection is crucial. The surgeon must discontinue the resection whenever the pancreatic margin is negative and, of course, when a total pancreatectomy is indicated. Nevertheless, a wide gray area exists. The real surgical problems are represented by i) IPMNs involving only a segment of the pancreatic gland, thus necessitating intraoperative histological examination of the resection and the decision as to “when to stop the resection”; ii) the intraoperative management of those margins which ar