1). Non-cancerous cysts such as IPMN’s can be precancerous, particularly if they are present in the main duct or communicate with the main duct. They can increase in size blocking a duct leading to acute pancreatitis and over time can become chronic and potentially become pancreatic cancer.

2). Risk associated with doing a biopsy depends on the location of the cyst. If the cyst is in the main duct in the head of the pancreas, it is less of a challenge then in the network of branch ducts which progressively get smaller. There is risk of creating pancreatitis in doing a biopsy on ducal cysts.

3). IPMN’s are generally slow growing and take years to transform into malignancy. It also depends how long the IPMN was present before it was discovered. When an IPMN is detected on imaging, it often is found incidentally. It could have been present for quite some time. The IPMN’s in the main duct are the ones with a higher propensity towards malignancy. The IPMN’s in branch ducts can become problematic just from increasing size that results in ductal dilation. If the digestive enzymes get blocked from reaching the intestine and become activated, it leads to excruciating pain as the pancreatic disease is being digested by the enzymes.

4). The Whipple procedure has been around since 1935. The surgeon who will be doing the procedure is the one to ask regarding outcomes on the patients he/she treated. Speaking for myself, I underwent a Whipple in 2012. I had no complications, had a smooth recovery and live normally. I only take supplemental enzymes when I have meals containing fat to ensure complete digestion.

5). Mortality rate is very low for the Whipple. Where I had my Whipple done, it was 0.3% for that medical center. Again that figure will be specific to the institution and surgeon. The recommendation is to go to a high-volume center where the surgeon has done a significant number of Whipples per year. I believe PanCan.org recommends at least 90/year. PanCan.org and provide names of institutions, surgeons and data on mortality rates. Call 877.272.6226, M-F, 7:00am-5:00pm, PT.

6). Recovery time is specific to the patient. Physical status is a major factor. Co-morbidities plays a role. The better shape one is in, the shorter the recovery. The amount of time under anesthesia plays a role. The longer the anesthesia, the longer the recovery. I was back traveling making long trips by airplane after 8 weeks. Some people will take much longer. Again it depends on the physical condition and health prior to surgery and maintaining exercise and a positive outlook during recovery that will factor in to feeling better.

@mikewdby
Hello There!

I had a surprise 'incidental finding' on a CT Abdomen done in the ER in August; looking for an ulcer, as I had horrible burning pain in the epigastric region. Endoscopy confirmed I did have a marginal ulcer. But..... the attending radiologist (Mayo Clinic Florida) found an IPMN 2 cm solid enhancing non-malignant cystic mass in the head of the pancreas on that CT August 10, '22. As I am blessed to work in Radiology @Mayo Florida; immediately was scheduled for MR Pancreas, which confirmed this mass. Scheduled the next week for consultation with THE pancreatic surgeon most highly esteemed and has done a vast amount of pancreatic surgeries. His nurse scheduled my Whipple procedure for Nov 7, '22. The ball got rolling very swiftly and I am beyond grateful - have worked through the anxiety that came with this new finding, although still have a roller coaster of emotions, facing this open invasive surgery in less than 3 weeks. BUT....since this was caught very early the surgeon is very confident Whipple surgery will ensure a great outcome. Of course, there is the intraoperative biopsy(ies) to await results of, but I have faith that everything will be clear. No symptoms whatsoever associated with this cystic mass. I will know my CA number on 10.24 with labs. It is very crucial for your body to keep a positive outlook - worrying never helps with anything we face in this life, medically or otherwise. I strive to live for the moment and for today. And above ALL, trust that God is in control. It is very evident to me that HE had me go to the ER that night in August in such pain; the ER attending physician ordered the CT Abdomen.....I would not have known this pre-malignant cyst even existed, had it not been for the insight of this wonderful ER physician's decision to order the CT.

I do not have answers to your questions, but am positive that your Mayo physicians will be happy to answer them all. Always remember that we are all so different in anatomy and such...everyone's experience will not be the same pre and post-op. I do have the same questions you asked. When I met with the oncology surgeon in consultation, I was too stunned to speak and did not know the questions to ask. I will address more questions at my preoperative appointments in late October.

I pray the best outcome for you and can fully relate to your present health situation. It is the 'unknown' that is the most difficult.

My best to you! Prayers for you as well!!!

Victoria