TY - JOUR
T1 - Pancreatic Cysts-Part 2
AU - Lennon, Anne Marie
AU - Canto, Marcia Irene
N1 - Funding Information:
This study was supported by the Lustgarten Foundation for Pancreatic Cancer Research, the Sol Goldman Center for Pancreatic Cancer Research, the Virginia and D.K. Ludwig Fund for Cancer Research, Susan Wojcicki and Dennis Troper, the Michael Rolfe Foundation, and the National Institutes of Health grants P50 CA62924, R01CA176828, and U01 CA210170.
Publisher Copyright:
© 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017
Y1 - 2017
N2 - The management of pancreatic cysts is a common problem faced by physicians and surgeons. Pancreatic cysts are important because some of them are mucin-producing cysts (MPCs), which may harbor or develop pancreatic ductal adenocarcinoma. Thus, accurate classification of pancreatic cysts and diagnosis ofMPCs offer a potential for the prevention or early detection of pancreatic cancer. However, the diagnosis and management of asymptomatic pancreatic cysts are complicated by 2 factors. First, incidentally detected pancreatic cysts are often misdiagnosed as branch duct intraductal papillary mucinous neoplasms. Although most are MPCs, there are other types of cysts, such as serous cystadenomas, which are managed differently. Second, only a minority ofMPCs will ultimately develop into invasive pancreatic ductal adenocarcinoma. Thus, on the one hand, pancreatic cysts offer a unique opportunity to identify precursors to pancreatic cancer and improve outcomes. On the other hand, misdiagnosis and overzealous testing or unnecessary surgery may lead to high cost and harm to patients. Several guidelines have been developed by various groups for the management of pancreatic cysts. In this article, we review the strengths and weaknesses of the American Gastroenterology Association guidelines, highlight key recommendations requiring further validation, and provide our balanced approach to diagnosing and managing pancreatic cysts.
AB - The management of pancreatic cysts is a common problem faced by physicians and surgeons. Pancreatic cysts are important because some of them are mucin-producing cysts (MPCs), which may harbor or develop pancreatic ductal adenocarcinoma. Thus, accurate classification of pancreatic cysts and diagnosis ofMPCs offer a potential for the prevention or early detection of pancreatic cancer. However, the diagnosis and management of asymptomatic pancreatic cysts are complicated by 2 factors. First, incidentally detected pancreatic cysts are often misdiagnosed as branch duct intraductal papillary mucinous neoplasms. Although most are MPCs, there are other types of cysts, such as serous cystadenomas, which are managed differently. Second, only a minority ofMPCs will ultimately develop into invasive pancreatic ductal adenocarcinoma. Thus, on the one hand, pancreatic cysts offer a unique opportunity to identify precursors to pancreatic cancer and improve outcomes. On the other hand, misdiagnosis and overzealous testing or unnecessary surgery may lead to high cost and harm to patients. Several guidelines have been developed by various groups for the management of pancreatic cysts. In this article, we review the strengths and weaknesses of the American Gastroenterology Association guidelines, highlight key recommendations requiring further validation, and provide our balanced approach to diagnosing and managing pancreatic cysts.
KW - AGA
KW - Guidelines
KW - IPMN
KW - Pancreatic cysts
UR - http://www.scopus.com/inward/record.url?scp=85020914023&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85020914023&partnerID=8YFLogxK
U2 - 10.1097/MPA.0000000000000841
DO - 10.1097/MPA.0000000000000841
M3 - Review article
C2 - 28609361
AN - SCOPUS:85020914023
VL - 46
SP - 745
EP - 750
JO - Pancreas
JF - Pancreas
SN - 0885-3177
IS - 6
ER -