Dilated pancreatic duct: Should I get a second opinion?

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.

My reply didn’t end up where expected so replying again.

I have been referred to the gastro team at Mayo Rochester and have an appointment to speak with a nurse next week.

Praying that Mayo will see me as the local resources are fine but do only a handful of these surgeries each year.

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 I belatedly saw your post and am wondering how your husband is doing. I have very similar symptoms, no jaundice but MRCP was similar. Thank you.

I have not posted in a while, but I too have dilation of bile and pancreatic ducts that showed up on multiple exams. including the MCRP. I recently had an appointment (finally) with a hepatologist, whose intellect I found to be astonishing. She advised that the radiologist cannot diagnose any kind of liver or pancreatic disease and that I would need to have an ECRP, which will be scheduled in San Francisco in the near future. She wants to find out what is blocking the bile duct(s). She further explained to me that my long term opiate use could be the culprit, which I was well aware of. I am still a but mystified however, because after she ordered and I had, many lab tests completed, when I asked her if I needed to be concerned about many of the flags, she referred me back to my PCP for explanations. She also told me that she was not concerned about liver cysts, which was a relief. A biopsy will not be needed either, good. Having said this, I am still frustrated because my clinicians are very evasive when it comes to answering my questions, which are probably too direct. I had more labs which have confirmed a diagnosis of hypogammaglobulinemia. I am also being screened for multiple myeloma, a disease which killed my father. Having said all of this, I have pretty much decided to just keep moving forward, not giving any of these findings a lot of energy because it is wasted thought and energy. If my clinicians are not concerned, then I am not going to continue to fight with them in an effort to get whatever treatment may be available to me. I will simply continue with the testing, continue with my art, which has really taken off, and continue to express kindness to others and give to my community. If there are treatments available and offered, I will follow up. If not, I will move on. I am maintaining a weight of about 95 pounds, still have little appetite and am malnourished because I have no appetite as a result of the bile duct issues. Life is too short to be worrying all the time over something I cannot control.

Best of luck to you. If I can be of any help please do not hesitate to inquire. I will continue to post as I receive new information. This patient portal has pretty much become a lifeline to me and has really had a positive impact on my life, and I thank all of you.