AB245. SOH26AB_0329. Compliance of intraductal papillary mucinous neoplasm surveillance at University Hospital Galway with the Kyoto guideline
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AB245. SOH26AB_0329. Compliance of intraductal papillary mucinous neoplasm surveillance at University Hospital Galway with the Kyoto guideline

Ali Shabu, Oisín O’Donnell, Mark Regan

Department of General Surgery, University Hospital Galway, Galway, Ireland

Background: Intraductal papillary mucinous neoplasms (IPMNs) are recognised precursors to pancreatic ductal adenocarcinoma. The risk of malignant transformation varies with duct involvement, estimated at 40–95% for main duct IPMNs and 6–40% for branch duct IPMNs. The revised Kyoto guideline offers risk-stratified recommendations for surveillance, including imaging intervals, modality, and criteria for cessation. However, adherence to these recommendations in routine clinical practice is often inconsistent. This audit aimed to evaluate compliance with the Kyoto surveillance standards at University Hospital Galway (UHG) to identify gaps in follow-up and documentation.

Methods: A retrospective audit of 63 patients with radiologically confirmed IPMN was undertaken. Data extracted included cyst morphology, size, and risk features; indication for surveillance; documentation of a formal surveillance plan; adherence to Kyoto-recommended intervals; imaging modality and uptake; multidisciplinary team (MDT) discussion; and justification for deviation or cessation. Descriptive statistics were used to compare observed practice with guideline standards.

Results: Surveillance was indicated in 56/63 (89%). A formal surveillance plan was documented in 25/56 (45%), and only 5/56 (9%) received surveillance compliant with the Kyoto intervals. Across the cohort, 52/63 (83%) did not receive appropriately timed imaging. Surveillance imaging occurred in 37/63 (59%), and MDT discussion was recorded in 14/63 (22%). Common contributors to non-adherence included absent plans and deviation from recommended intervals.

Conclusions: Compliance with the Kyoto surveillance recommendations at UHG is limited and reflects broader challenges in delivering structured follow-up for IPMN. Standardised documentation, improved radiology integration, and scheduled re-audit are recommended.

Keywords: Intraductal papillary mucinous neoplasm (IPMN); surveillance; guideline adherence; audit; pancreatic cyst

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab245
Cite this abstract as: Shabu A, O’Donnell O, Regan M. AB245. SOH26AB_0329. Compliance of intraductal papillary mucinous neoplasm surveillance at University Hospital Galway with the Kyoto guideline. Mesentery Peritoneum 2026;10:AB245.

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