@johnbc, have you had the ultrasound in the meantime? Did they find the cause of the dialation?

I too have dilated pancreatic and liver ducts. Have you had an MCRP? I believe this is the gold standard in investigating the type of problem you describe. I recently had a follow up CT scan which did not show any changes in the size of the dilation, but I still suffer the consequences of having the problems that come with dilation of both liver and pancreatic ducts/
Best of luck

The MRI/MRCP found the gallbladder and bile ducts appear unremarkable.

To recap they decided not to do a biopsy with the first EUS to avoid pancreatitis (which I believe may already be present since I have digestive symptoms) and now after a recent MRI/MRCP are again recommending EUS with possible biopsy.

Is it possible for pancreatitis by itself to dilate the pancreatic duct to 8-10 mm? Also, should the various imaging already done have shown an IPMN if there was one?

Thank you

My 8mm main duct pancreatic dilation was found incidental to a bout of diverticulitis. No connection. I do have an IPMN but biopsies have come back negative after an EUS/ERCP. I am currently monitoring any changes vis MRI/MRCP every 6 months. Have had no pain or symptoms at all. I did seek other opinions and the feeling is I should consider a prophylactic Whipple because of my current good health with no underlying conditions. I have had this for 9 years but only recently was told about the dilation. Still conflicted what to do, but as long as I feel fine I am hesitant to do that surgery. Hope this helps.

The information has been helpful, thank you all.

My doctors think the observations noted above are enough to diagnose a MD IPMN in the pancreas head, along with the digestive issues. My concern is that there has been no confirmation through biopsy though surgery has been recommended.

That’s why I asked if any of the imaging done so far could conclusively determine an IPMN presence, as apparently none has directly. Perhaps papillary projections and fishmouth ampulla are indicative enough. I just don’t know and also wish to be sure before surgery.

Have you had opinions about surgery from more than one surgeon?

I have been in contact with Mayo in Rochester and referred to their gastro team. Have an appointment next week to speak with a nurse there.

Is it unusual to proceed to surgery w/o a biopsy or some other definitive proof there is an IPMN?

The surgeon believes the CT scan, EUS w/o biopsy and MRI/MRPC provide sufficient proof of IPMN even though none conclusively identified an IPMN and recommends the surgery.

The surgeon offered to request a new EUS with biopsy if I wish but they said they didn’t believe it was necessary and that it could result in pancreatitis which could be problematic.

The surgeon seems quite competent but I just have little knowledge to base my decision upon.

Really hoping Mayo will see me as I know they have much experience with these topics.

Hi there, my mother is 78 and has lived with nausea almost non-stop for the last couple of years and significant weight loss. She had her gallbladder removed in 2019 which did nothing and due to the doctor nicking her in surgery causing a huge hematoma, she’s never been the same and has undergone multiple tests that can’t explain her nausea. Fast forward this year we were blessed that she found a PA who actually listened to her issues and believed her . So she ordered some tests the first was a CT that showed abnormal liver and biliary tract, then an MRI/MRCP on May 2nd, it showed “moderate intra and extra hepatic biliary ductal dilation and mild suspected pancreatic ductal dilation; question soft tissue lesion at distal CBD producing obstruction…further evaluation with EUS/ERCP recommended”.
She is having the EUC on May 10th with most likely the ERCP afterwards.

I don’t like surprises having had breast cancer myself 14 years ago so I am hoping I can find help in getting prepared. Is it a high possibility that she has some type of cancer?

Any help is greatly appreciated, thank you and God bless everyone struggling!
K