{"entity":{"id":"paper-fukuoka-2017-consensus-guidelines-ipmn-pancreatology-2017","kind":"paper","name":"Revised international consensus Fukuoka guidelines for the management of IPMN of the pancreas (2017)","aka":[],"tldr":"The international rulebook for pancreatic cysts: which features mean a cyst should be removed straight away (high-risk stigmata), which mean it needs a closer look with endoscopic ultrasound (worrisome features), and how often smaller cysts should be scanned.","summary":"Revision of the 2012 Fukuoka consensus from the International Association of Pancreatology for intraductal papillary mucinous neoplasms and mucinous cystic neoplasms. High-risk stigmata that indicate resection are obstructive jaundice from a cyst in the head, an enhancing mural nodule of 5 mm or more and a main pancreatic duct of 10 mm or more. Worrisome features that indicate endoscopic ultrasound include cyst size of 3 cm or more, enhancing mural nodule under 5 mm, thickened enhancing cyst walls, main duct 5 to 9 mm, abrupt change in duct calibre with distal atrophy, lymphadenopathy, raised CA19-9 and cyst growth of 5 mm or more in two years.\n\nSurveillance intervals for cysts without these features are set by cyst size, and the revision addresses surgery for main-duct IPMN, extent of resection and follow-up after resection.","asOf":"2026-09-21","links":[{"label":"Pancreatology 2017","url":"https://doi.org/10.1016/j.pan.2017.07.007"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28735806/"}],"tags":[],"related":[],"cancers":["ipmn-cystic-precursors","pancreatic"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"Pancreatology","year":2017,"doi":"10.1016/j.pan.2017.07.007","pmid":"28735806","authors":"Tanaka M, Fernández-Del Castillo C, Kamisawa T, et al.","paperType":"guideline","findings":["High-risk stigmata for resection: obstructive jaundice, enhancing mural nodule 5 mm or more, main duct 10 mm or more.","Worrisome features for endoscopic ultrasound: cyst 3 cm or more, small nodule, thickened wall, main duct 5 to 9 mm, raised CA19-9, growth 5 mm in two years, among others.","Size-based surveillance intervals for cysts without worrisome features."],"whatItMeans":"Most radiology reports and surgical decisions on pancreatic cysts still follow the Fukuoka criteria or their 2024 Kyoto revision.","caveats":["Expert consensus resting on retrospective series; no randomised trial of surveillance strategies exists.","The criteria are sensitive but not specific, so many resected cysts turn out to be low grade."],"changedPractice":true},"route":"/key-papers/paper-fukuoka-2017-consensus-guidelines-ipmn-pancreatology-2017/","neighbours":{"cancer":[{"id":"ipmn-cystic-precursors","kind":"cancer","name":"Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","route":"/cancers/ipmn-cystic-precursors/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}]}}