Document Detail


Pancreatic cystic neoplasms: management and unanswered questions.
MedLine Citation:
PMID:  23622140     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Approximately 10% of persons 70 years old or older are now diagnosed with pancreatic cysts, but it is not clear which ones require additional analysis, interventions, or follow-up. Primary care doctors rely on gastroenterologists for direction because no one wants to miss a diagnosis of pancreatic cancer, but meanwhile there is pressure to limit use of diagnostic tests and limit costs. We review the different cystic neoplasms of the pancreas and diagnostic strategies based on clinical features and imaging data. We discuss surgical and nonsurgical management of the most common cystic neoplasms, based on the recently revised Sendai guidelines. Intraductal papillary mucinous neoplasm (particularly the branch duct variant) is the lesion most frequently identified incidentally. We report what is known about its pathology, its risk of developing into pancreatic ductal adenocarcinoma, the pros and cons of current guidelines for management, and the potential role of endoscopic ultrasound in determining cancer risk. We also review surgical treatment and strategies for surveillance of pancreatic cysts.
Authors:
James J Farrell; Carlos Fernández-Del Castillo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastroenterology     Volume:  144     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-04-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1303-15     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Yale Pancreas Center and Interventional Endoscopy, Yale School of Medicine, New Haven, Connecticut. Electronic address: james.j.farrell@yale.edu.
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