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IPMNs are classified as main duct type, branch duct type, and combined type, according to the area of involvement of the pancreatic ductal system [22, 23].
All main duct type IPMN are recommended for resection, whereas branch duct type IPMN less than 3 cm in size and lacking mural nodules could potentially be managed conservatively [18].
The best predictor of malignant potential, however, is tumour location, with the main duct type having a 70% chance of harbouring malignancy compared with 25% for the branch duct type [29].
main duct type side branch or branch duct type.
Depending on whether the main pancreatic duct or a side branch is involved, these neoplasms have been divided into: main duct type side branch or branch duct type.
The main duct type of IPMT is thought to be more malignant and requires surgical treatment in the form of a total or subtotal pancreatectomy.
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All main-duct type IPMN should be resected because of the high malignancy rate whereas branch-duct type IPMN demonstrating favourable features (<3 cm size and absence of mural nodules) may be managed conservatively [ 12].
Based on these reports, the following clinical characteristics were identified: 1) female predominance (80 %), 2) predominance of type 1 (complete pancreatic divisum) (80 %), 3) tumor location in the dorsal pancreas (80 %) rather than in the ventral pancreas, and 4) a predominance of the branch-duct type (60 %) over the main-duct type.
Kimura et al. has proposed a classification system for AUPBD where type 1 is defined as the pancreatic duct joined to the common bile duct (as the main duct) and type 2 is defined as the common bile duct joined to the pancreatic duct (as the main duct) [26].
Moderate (12 of 28) or strong (13 of 28) cytoplasmic staining for BLT2 was detected in 25 of 28 tissues with IPMNs regardless of whether they were benign or malignant or if they are main or branch duct type lesions.
Biliary leaks have been classified by Nagano et al. [16] into four types: Type A, minor leaks from small bile radicles on the surface of the liver; Type B, leaks from inadequate closure of the major bile duct branches on the liver's surface; Type C, injury to the main duct commonly near the hilum; Type D, leakage due to a transected duct disconnected from the main duct.
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