Do not request surveillance investigations for patients with pancreatic cysts who are poor surgical candidates, irrespective of cysts nature and characteristics

Do not request surveillance investigations for patients with pancreatic cysts who are poor surgical candidates, irrespective of cysts nature and characteristics

Type of practice

Imaging

Age

Adult, Geriatric

Topic Area

Gastroenterology

Pancreatic cystic lesions are an increasingly common finding, usually incidentally detected at abdominal investigations requested for other indications, due to the increased quality of imaging modalities. Patients with asymptomatic pancreatic cysts who are medically unfit for surgery, or unwilling to undergo surgery, should not undergo further investigations, irrespective of cyst size and characteristics, as these are not expected to change the clinical management.

Sources

1. De Jong K, Nio CY, Hermans JJ, et al. High prevalence of pancreatic cysts detected by screening magnetic resonance imaging examinations. Clin Gastroenterol Hepatol 2010;8:806–11
2. European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut 2018;67:789–804
3. Elta GH, Enestvedt BK, Sauer BG, et al. ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts. Am J Gastroenterol 2018;113:464–479
4. Scheiman JM , Hwang JH , Moayyedi P. American gastroenterological association technical review on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology 2015;148:824–48
5. Sahora K, Ferrone CR, Brugge WR, et al. Effects of comorbidities on outcomes of patients with intraductal papillary mucinous neoplasms. Clin Gastroenterol Hepatol 2015;13:1816–23
6. Kawakubo K, Tada M, Isayama H, et al. Risk for mortality from causes other than pancreatic cancer in patients with intraductal papillary mucinous neoplasm of the pancreas. Pancreas 2013;42:687–91

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.