Is there a proper type of management for branch-duct intraductal papillary mucinous tumors of the pancreas?

The Dr. Tolstunov’s letter published in the present issue of JOP. Journal of the Pancreas [1] is very interesting, because it pointed out the controversial management approach for the branch-duct intraductal papillary mucinous neoplasms (IPMNs) of the pancreas, even in high volume centers for pancreatic disease. The final questions, “Have I been correct with my decision so far in delaying the surgery?” and “Should my mother have had her surgery a long time ago?” pointed out the real problems both for patients (and her/his relatives) and surgeons.