[Intraductal papillary mucinous neoplasm of the pancreas]

The diagnosis of cystic pancreatic lesions is raised more often within the last years. This is due to the fact that diagnostic opportunities and modalities such as endosonography (EUS), magnetic resonance imaging (MRI), magnetic resonance cholangio-pancreatography (MRCP), and computertomography (CT) have both improved and are more widely used. As such new recommendations were needed, since the knowledge on cystic pancreatic lesions has increased after the last consensus statement published in 2006.  In this review the main aspects of the recent consensus statements for diagnosis and therapy or in some cases the surveillance strategy of intraductal papillary mucinous neoplasm will be summarized. Main duct IPMN will in most cases in surgically "fit" patients be resected, since the risk of malignancy is high in this entity. In patients with branch duct IPMN a careful "watch and wait" strategy can be applied if no "worrisome features" or "high-risk stigmata" can be detected. MRI is the imaging modality of choice, while EUS should be applied in centers with expertise.