Table 3.

Absolute and relative indications for surgery in IPMN

Absolute indications	Relative indications
Positive cytology for malignancy/HGD	Grow-rate ≥5 mm/year
Solid mass	Increased levels of serum CA 19.9 (>37 U/mL)*
Jaundice (tumour related)	MPD dilatation between 5 and 9.9 mm
Enhancing mural nodule (≥5 mm)	Cyst diameter ≥40 mm
MPD dilatation ≥10 mm	New onset of diabetes mellitus
	Acute pancreatitis (caused by IPMN)
	Enhancing mural nodule (<5 mm)

*In the absence of jaundice.

HGD, high-grade dysplasia; IPMN, intraductal papillary mucinous neoplasm; MPD, main pancreatic duct.