Clinical approach to incidental pancreatic cysts

World Journal of Gastroenterology : WJG
Austin L Chiang, Linda S Lee

Abstract

The approach to incidentally noted pancreatic cysts is constantly evolving. While surgical resection is indicated for malignant or higher risk cysts, correctly identifying these highest risk pancreatic cystic lesions remains difficult. Using parameters including cyst size, presence of solid components, and pancreatic duct involvement, the 2012 International Association of Pancreatology (IAP) and the 2015 American Gastroenterological Association (AGA) guidelines have sought to identify the higher risk patients who would benefit from further evaluation using endoscopic ultrasound (EUS). Not only can EUS help further assess the presence of solid component and nodules, but also fine needle aspiration of cyst fluid aids in diagnosis by obtaining cellular, molecular, and genetic data. The impact of new endoscopic innovations with novel methods of direct visualization including confocal endomicroscopy require further validation. This review also highlights the differences between the 2012 IAP and 2015 AGA guidelines, which include the thresholds for sending patients for EUS and surgery and methods, interval, and duration of surveillance for unresected cysts.

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Citations

May 25, 2016·Surgery·Jordan M CloydGeorge A Poultsides
Nov 2, 2017·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Go Eun KimYong Yeon Jeong
Aug 21, 2020·ANZ Journal of Surgery·Trisha KananiAshley Dennison
Feb 25, 2021·World Journal of Gastrointestinal Endoscopy·Raquel Herranz PérezCecilio Santander Vaquero

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