European evidence-based guidelines on pancreatic cystic neoplasms

The European Study Group on Cystic Tumours of the Pancreas

Research output: Contribution to journalReview article

Abstract

Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring <40 mm without an enhancing nodule. Relative indications for surgery in IPMN include a main pancreatic duct (MPD) diameter between 5 and 9.9 mm or a cyst diameter ≥40 mm. Absolute indications for surgery in IPMN, due to the high-risk of malignant transformation, include jaundice, an enhancing mural nodule >5 mm, and MPD diameter >10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.

Original languageEnglish (US)
Pages (from-to)789-804
Number of pages16
JournalGut
Volume67
Issue number5
DOIs
StatePublished - May 1 2018

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Pancreatic Neoplasms
Guidelines
Neoplasms
Neoplasms, Cystic, Mucinous, and Serous
Gastroenterology
Radiology
Endoscopy
Cysts
Pancreas
Biomarkers
Pathology

ASJC Scopus subject areas

  • Gastroenterology

Cite this

The European Study Group on Cystic Tumours of the Pancreas (2018). European evidence-based guidelines on pancreatic cystic neoplasms. Gut, 67(5), 789-804. https://doi.org/10.1136/gutjnl-2018-316027

European evidence-based guidelines on pancreatic cystic neoplasms. / The European Study Group on Cystic Tumours of the Pancreas.

In: Gut, Vol. 67, No. 5, 01.05.2018, p. 789-804.

Research output: Contribution to journalReview article

The European Study Group on Cystic Tumours of the Pancreas 2018, 'European evidence-based guidelines on pancreatic cystic neoplasms', Gut, vol. 67, no. 5, pp. 789-804. https://doi.org/10.1136/gutjnl-2018-316027
The European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut. 2018 May 1;67(5):789-804. https://doi.org/10.1136/gutjnl-2018-316027
The European Study Group on Cystic Tumours of the Pancreas. / European evidence-based guidelines on pancreatic cystic neoplasms. In: Gut. 2018 ; Vol. 67, No. 5. pp. 789-804.
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abstract = "Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring <40 mm without an enhancing nodule. Relative indications for surgery in IPMN include a main pancreatic duct (MPD) diameter between 5 and 9.9 mm or a cyst diameter ≥40 mm. Absolute indications for surgery in IPMN, due to the high-risk of malignant transformation, include jaundice, an enhancing mural nodule >5 mm, and MPD diameter >10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.",
author = "{The European Study Group on Cystic Tumours of the Pancreas} and {Del Chiaro}, Marco and Besselink, {Marc G.} and Lianne Scholten and Bruno, {Marco J.} and Cahen, {Djuna L.} and Gress, {Thomas M.} and {van Hooft}, {Jeanin E.} and Lerch, {Markus M.} and Julia Mayerle and Thilo Hackert and Sohei Satoi and Alessandro Zerbi and David Cunningham and {De Angelis}, Claudio and Marc Giovannini and Enrique de-Madaria and Peter Hegyi and Jonas Rosendahl and Helmut Friess and Riccardo Manfredi and Philippe L{\'e}vy and Real, {Francisco X.} and Alain Sauvanet and Hilal, {Mohammed Abu} and Giovanni Marchegiani and Irene Esposito and Paula Ghaneh and Engelbrecht, {Marc R.W.} and Paul Fockens and {van Huijgevoort}, {Nadine C.M.} and Christopher Wolfgang and Claudio Bassi and Gubergrits, {Natalya B.} and Caroline Verbeke and G{\"u}nter Kl{\"o}ppel and Aldo Scarpa and Giuseppe Zamboni and O'Broin-Lennon, {Anne Marie} and Malin Sund and Nikolaos Kartalis and Lars Grenacher and Massimo Falconi and Urban Arnelo and Kopchak, {Kostantin V.} and Kofi Oppong and Colin McKay and Truls Hauge and Kevin Conlon and Mustapha Adham and Ceyhan, {G{\"u}ralp O.}",
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AU - The European Study Group on Cystic Tumours of the Pancreas

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AU - Bruno, Marco J.

AU - Cahen, Djuna L.

AU - Gress, Thomas M.

AU - van Hooft, Jeanin E.

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AU - Hackert, Thilo

AU - Satoi, Sohei

AU - Zerbi, Alessandro

AU - Cunningham, David

AU - De Angelis, Claudio

AU - Giovannini, Marc

AU - de-Madaria, Enrique

AU - Hegyi, Peter

AU - Rosendahl, Jonas

AU - Friess, Helmut

AU - Manfredi, Riccardo

AU - Lévy, Philippe

AU - Real, Francisco X.

AU - Sauvanet, Alain

AU - Hilal, Mohammed Abu

AU - Marchegiani, Giovanni

AU - Esposito, Irene

AU - Ghaneh, Paula

AU - Engelbrecht, Marc R.W.

AU - Fockens, Paul

AU - van Huijgevoort, Nadine C.M.

AU - Wolfgang, Christopher

AU - Bassi, Claudio

AU - Gubergrits, Natalya B.

AU - Verbeke, Caroline

AU - Klöppel, Günter

AU - Scarpa, Aldo

AU - Zamboni, Giuseppe

AU - O'Broin-Lennon, Anne Marie

AU - Sund, Malin

AU - Kartalis, Nikolaos

AU - Grenacher, Lars

AU - Falconi, Massimo

AU - Arnelo, Urban

AU - Kopchak, Kostantin V.

AU - Oppong, Kofi

AU - McKay, Colin

AU - Hauge, Truls

AU - Conlon, Kevin

AU - Adham, Mustapha

AU - Ceyhan, Güralp O.

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N2 - Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring <40 mm without an enhancing nodule. Relative indications for surgery in IPMN include a main pancreatic duct (MPD) diameter between 5 and 9.9 mm or a cyst diameter ≥40 mm. Absolute indications for surgery in IPMN, due to the high-risk of malignant transformation, include jaundice, an enhancing mural nodule >5 mm, and MPD diameter >10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.

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