Ampullary intraductal papillary mucinous neoplasm – Is it main duct type or branch type IPMN?

IPMN is a precancerous state of the pancreas mainly if it has arisen in the main pancreatic duct. Ampulla of papilla of Vater is part of the main pancreatic duct but also that of the biliary duct. This common channel is important for provoking cysts and cancers by facilitating mixture of lecithin of bile and phospholipase A of pancreatic juice leading to formation of lysolecithin, one of the most potent cancerogens of this region. However, endoscopic papillotomy can separate bile and pancreatic juice, prevent cancer as happened with choledochocele. It might be effective also in IPMN of the ampulla, an extremely…