There are still debated about surveillance interval, duration, diagnostic modality and treatment for intraductal papillary mucinous neoplasm (IPMN) of the pancreas. In recent guidelines, ‘high risk stigmata (HRS)’ and ‘worrisome feature (WF)’ are defined as predictive factors for malignancy in IPMN. IPMNs with HRS and main duct- IPMN are more likely to accompany malignancies, thus require surgery. However, in the case of only WF, since the risk of malignancy is different for each factor, the management decision can be variable according to the number of overlapping WFs. In addition, for segmental main pancreatic duct dilatation without enhancing mural nodules, careful surveillance might be considered rather than immediate surgery. In IPMN patients with elderly or severe comorbidities, treatment strategy should be determined based on surgical and malignant risk assessment. To date, the natural course of IPMN patients with HRS and WF is not well understood, thus further studies with a large number of patients are needed.

서 론
본 론
    1. 췌장 IPMN의 진료지침
    2. High risk stigmata와 worrisome feature의 추가적평가
    3. 악성 위험 인자들의 악성도 차이와 역동적 변화의 중요성
    4. 주췌관 침범 IPMN의 치료 전략
결 론
요 약
ORCID
REFERENCES

• 김태현(원광대학교병원 췌장담도내과) | Tae Hyeon Kim (Division of Biliopancreas, Department of Internal Medicine, Wonkwang University Medical School and Hospital, Iksan, Korea) Corresponding author
• 전형구(원광대학교병원 췌장담도내과) | Hyung Ku Chon (Division of Biliopancreas, Department of Internal Medicine, Wonkwang University Medical School and Hospital, Iksan, Korea)