Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Search research articles

Related Experiment Video

Updated: Jun 13, 2026

Robotic Duodenum-preserving Total Pancreatic Head Resection for Intraductal Papillary Mucinous Neoplasms

Robotic Duodenum-preserving Total Pancreatic Head Resection for Intraductal Papillary Mucinous Neoplasms

Published on: April 17, 2026

'UNMIXING' Mixed-Type Intraductal Papillary Mucinous Neoplasms: Rethinking Malignancy Risk Beyond Radiological

Federico De Stefano^1,2, Peter Fagenholz¹, Jon M Harrison¹

¹Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Annals of Surgery

|June 12, 2026

Summary

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

The Conundrum of Compensation Based on Relative Value Units.

Journal of the American College of Surgeons·2026

Same author

The New Helium Criticality: An Emerging Vulnerability for MRI.

Journal of the American College of Radiology : JACR·2026

Same author

ASO Visual Abstract: Colloid Carcinoma of the Pancreas: A Distinct and Less Aggressive Entity in the Spectrum of Pancreatic Malignancies.

Annals of surgical oncology·2026

Same author

Colloid Carcinoma of the Pancreas: A Distinct and Less Aggressive Entity in the Spectrum of Pancreatic Malignancies.

Annals of surgical oncology·2026

Same author

Disparities in the diagnosis and management of exocrine pancreatic insufficiency in resectable vs metastatic pancreatic cancer.

The oncologist·2026

Same author

Long-term Outcomes of Spleen-preserving Distal Pancreatectomy With or Without Preservation of Splenic Vessels: A Bi-institutional Experience.

Annals of surgery·2025

Same journal

Trends in Metabolic and Bariatric Surgery and GLP-1 Receptor Agonist Use Among Adolescents with Severe Obesity.

Annals of surgery·2026

Same journal

The Ambulatory Surgery Center Paradox: Why 60% of Surgeries Occur Where 2% of AI Research Happens.

Annals of surgery·2026

Same journal

Medical Student First Authorship in High-Impact Surgical Journals: Longitudinal Trends and Institutional Concentration, 2000-2025.

Annals of surgery·2026

Same journal

Radial Margin Distance in Perihilar Cholangiocarcinoma: Defining Dual Cutoff Values of 0 and 1 mm.

Annals of surgery·2026

Same journal

Normothermic Machine and Regional Perfusion in U.S. DCD Liver Transplantation: A National Comparative Analysis Supporting Adoption as Standard of Care.

Annals of surgery·2026

Same journal

Invited Commentary to "Reforming Surgical Graduate Medical Education Toward Accreditation Aligned with Readiness for Independent Practice" by Ellison, et al.

Annals of surgery·2026

See all related articles

This summary is machine-generated.

Mixed-type intraductal papillary mucinous neoplasms (IPMNs) show a lower malignancy rate than previously thought, especially without high-risk indicators. This suggests current surgical selection criteria for these pancreatic cysts may need re-evaluation.

Area of Science:

Gastroenterology
Surgical Oncology
Pancreatic Pathology

Background:

Mixed-type intraductal papillary mucinous neoplasms (IPMNs) are often considered high-risk pancreatic cysts.
Existing data on mixed-IPMNs is limited and inconsistent, creating uncertainty about their true malignant potential.

Purpose of the Study:

To compare the malignancy rates of radiologically classified mixed-type IPMNs with main-duct (MD) and branch-duct (BD) IPMNs.
To assess the impact of high-risk stigmata and main pancreatic duct (MPD) dilatation on malignancy rates in mixed-IPMNs.

Main Methods:

Retrospective analysis of 836 surgically resected IPMNs from a single institution.
Classification of IPMNs based on preoperative imaging into mixed-type, MD-IPMN, and BD-IPMN categories.

Keywords:

intraductal papillary mucinous neoplasms main pancreatic duct malignancy mixed pancreatic cysts surveillance

Related Experiment Videos

Last Updated: Jun 13, 2026

Robotic Duodenum-preserving Total Pancreatic Head Resection for Intraductal Papillary Mucinous Neoplasms

Robotic Duodenum-preserving Total Pancreatic Head Resection for Intraductal Papillary Mucinous Neoplasms

Published on: April 17, 2026

Malignancy defined as high-grade dysplasia or invasive carcinoma.

Main Results:

Malignancy rates were 46.5% for mixed-IPMNs, 79.2% for MD-IPMNs, and 33.9% for BD-IPMNs.
In the absence of high-risk stigmata, mixed-IPMN malignancy rate decreased to 24.7%, similar to BD-IPMNs (20.2%).
Malignancy risk significantly increased only with multiple worrisome features or MPD dilatation of 7-8 mm.

Conclusions:

Mixed-IPMNs exhibit significant heterogeneity with a lower malignancy rate than previously reported in resected cohorts.
When high-risk stigmata are absent, most mixed-IPMNs are benign, indicating current risk stratification and surgical selection may be overestimated.
Further refinement of diagnostic criteria is needed for accurate risk assessment and surgical decision-making in IPMNs.