{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T03:34:15Z","timestamp":1793244855711,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surveillance of low\u2010risk branch\u2010duct intraductal papillary mucinous neoplasms is usually lifelong. Criteria to stop it after 5\u00a0years of stability in older patients have not been tested outside the center that devised them, nor has their economic value been measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To test these criteria in an independent cohort and measure the lesions missed and the resources released.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single\u2010center cohort of patients with a low\u2010risk lesion at diagnosis was followed for at least 12 months with cross\u2010sectional imaging at baseline and during surveillance. The outcome was any new worrisome feature or high\u2010risk stigma. Risk after stability was estimated by conditional analysis. Released resources were valued at the marginal cost beyond the fifth year and priced with fourteen tariffs. Sensitivity analyses addressed discounting, horizon, adherence and basket composition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 392 patients followed for 2375 person\u2010years, 66 (16.8%) developed a new feature; three had high\u2010grade dysplasia or carcinoma, and none died of the neoplasm. The 5\u2010year risk of a new feature did not fall with stability (14.3% after 2\u00a0years, 12.5% after five), but no resection and no high\u2010grade lesion occurred after 4\u00a0years. Discontinuation would have discharged 101 patients (25.8%), releasing 298 person\u2010years and 79,316 euro per 1000 patients entering surveillance, with no high\u2010grade lesion missed. Across health systems, the same rule released 42,000 to 170,000 euros.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Discontinuation missed no high\u2010grade lesion, although the upper bound of that rate remained 0.84 per 100 person\u2010years. The resources released varied more than fourfold between health systems and must be recomputed locally.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.70304","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:07:38Z","timestamp":1791544058000},"source":"Crossref","is-referenced-by-count":0,"title":["Discontinuing Surveillance of Low\u2010Risk Branch\u2010Duct Intraductal Papillary Mucinous Neoplasms in Routine Practice: An External Application of the \u201cTrivial\u201d Criteria and the Resources it Would Release in Fourteen Health Systems"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6638-4479","authenticated-orcid":false,"given":"Claudio","family":"Ricci","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Surgery (DIMEC) Alma Mater Studiorum University of Bologna  Bologna Italy"},{"name":"Division of Pancreatic Surgery IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"D'Ambra","sequence":"additional","affiliation":[{"name":"Division of Pancreatic Surgery IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Casarotto","sequence":"additional","affiliation":[{"name":"Division of Pancreatic Surgery IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Alberici","sequence":"additional","affiliation":[{"name":"Division of Pancreatic Surgery IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Ingaldi","sequence":"additional","affiliation":[{"name":"Division of Pancreatic Surgery IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5742-1339","authenticated-orcid":false,"given":"Marco","family":"Fichera","sequence":"additional","affiliation":[{"name":"Division of Pancreatic Surgery IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Mosconi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Surgery (DIMEC) Alma Mater Studiorum University of Bologna  Bologna Italy"},{"name":"Division of Radiology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Migliori","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Surgery (DIMEC) Alma Mater Studiorum University of Bologna  Bologna Italy"},{"name":"Division of Internal Medicine IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Casadei","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Surgery (DIMEC) Alma Mater Studiorum University of Bologna  Bologna Italy"},{"name":"Division of Pancreatic Surgery IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.05.017"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0121317"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2023.12.009"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2017.07.007"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102018\u2010316027"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575\u2010019\u20100195\u2010x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102023\u2010329961"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000378"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.06.022"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2025.12.004"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273\u2010021\u201001112\u20108"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000548886"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.07.019"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.08.032"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2020.10.040"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.1802"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102015\u2010310162"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.7010"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2025.10.029"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000006702"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2020.01.006"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2019.08.011"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2025.06.007"}],"container-title":["United European Gastroenterology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ueg2.70304","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ueg2.70304","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ueg2.70304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T03:28:44Z","timestamp":1793244524000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ueg2.70304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/ueg2.70304"],"URL":"https:\/\/doi.org\/10.1002\/ueg2.70304","archive":["Portico"],"relation":{},"ISSN":["2050-6406","2050-6414"],"issn-type":[{"value":"2050-6406","type":"print"},{"value":"2050-6414","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"article-number":"e70304"}}