Role of frozen section assessment for intraductal papillary and mucinous tumor of the pancreas

Figure 1 A fresh cut section just before frozen sectioning. The surgeon has orientated the margin by a guide mark stitch placed on the main duct.

Figure 2 On this frozen section, the main duct is dilated but its epithelium is normal without any intraductal papillary mucinous neoplasms lesion.

Figure 3 The main duct is focally involved by a low grade dysplastic intraductal papillary mucinous neoplasms (intraductal papillary mucinous neoplasms-adenoma) (arrows).

Figure 4 A borderline/moderate dysplasia intraductal papillary mucinous neoplasms involves a branch-duct (arrow). The surrounding pancreatic parenchyma is normal

Figure 5 Standard options to determine extent of pancreatectomy according to results of frozen sectioning of the pancreatic margin after pancreaticoduodenectomy and distal pancreatectomy. FS: Frozen sectioning; MD: Main duct; BD: Branch duct; CBD: Common bile duct).