A new model helps surgeons accurately differentiate main-duct intraductal papillary mucinous neoplasms from chronic pancreatitis when imaging results are unclear.

• Among 123 patients, intraductal nodules were found in 20% of MD-IPMN cases vs 2.4% in chronic pancreatitis (p=0.003).
• Ductal stones were present in 77.1% of chronic pancreatitis cases compared to just 2.5% in MD-IPMN (p<0.001).

The model shows high accuracy (AUC of 0.946; F1-score of 0.879) and remains reliable even in stone-negative scenarios.

• A web-based tool is available to aid clinical decision-making and standardize evaluations.