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Cystic lesions and intraductal neoplasms of the pancreas.
Best Pract Res Clin Gastroenterol. 2009; 23(1):35-48.BP

Abstract

Pancreatic cystic lesions are being detected more frequently given increased use of cross-sectional imaging modalities. The most common cysts encountered are mucinous cysts, which have malignant potential. As many of these lesions are incidental findings, it is important to further evaluate them with endoscopic ultrasound-guided fine needle aspiration for diagnostic purposes and risk stratification. These cysts either require surgical resection or surveillance given the malignant risk. Mucinous cystic neoplasms should be resected. Intraductal papillary mucinous neoplasia (IPMN) has consensus-guideline indications for resection. These include main duct diameter > or = 10 mm, a branch duct size > or = 3 cm, presence of a mural nodule, or cytology suspicious for malignancy. Additionally, all symptomatic cysts, regardless of etiology, should undergo resection. Branch duct IPMN is less aggressive that the main duct variety, and may be conservatively followed. However, the development of an established indication for resection should prompt surgery. Despite generalized guidelines, decisions regarding management of pancreatic cysts should be individualized, accounting for the malignant risk of the lesion and the surgical risk of the patient.

Authors+Show Affiliations

Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19258185

Citation

Fasanella, Kenneth E., and Kevin McGrath. "Cystic Lesions and Intraductal Neoplasms of the Pancreas." Best Practice & Research. Clinical Gastroenterology, vol. 23, no. 1, 2009, pp. 35-48.
Fasanella KE, McGrath K. Cystic lesions and intraductal neoplasms of the pancreas. Best Pract Res Clin Gastroenterol. 2009;23(1):35-48.
Fasanella, K. E., & McGrath, K. (2009). Cystic lesions and intraductal neoplasms of the pancreas. Best Practice & Research. Clinical Gastroenterology, 23(1), 35-48. https://doi.org/10.1016/j.bpg.2008.11.011
Fasanella KE, McGrath K. Cystic Lesions and Intraductal Neoplasms of the Pancreas. Best Pract Res Clin Gastroenterol. 2009;23(1):35-48. PubMed PMID: 19258185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cystic lesions and intraductal neoplasms of the pancreas. AU - Fasanella,Kenneth E, AU - McGrath,Kevin, PY - 2009/3/5/entrez PY - 2009/3/5/pubmed PY - 2009/5/29/medline SP - 35 EP - 48 JF - Best practice & research. Clinical gastroenterology JO - Best Pract Res Clin Gastroenterol VL - 23 IS - 1 N2 - Pancreatic cystic lesions are being detected more frequently given increased use of cross-sectional imaging modalities. The most common cysts encountered are mucinous cysts, which have malignant potential. As many of these lesions are incidental findings, it is important to further evaluate them with endoscopic ultrasound-guided fine needle aspiration for diagnostic purposes and risk stratification. These cysts either require surgical resection or surveillance given the malignant risk. Mucinous cystic neoplasms should be resected. Intraductal papillary mucinous neoplasia (IPMN) has consensus-guideline indications for resection. These include main duct diameter > or = 10 mm, a branch duct size > or = 3 cm, presence of a mural nodule, or cytology suspicious for malignancy. Additionally, all symptomatic cysts, regardless of etiology, should undergo resection. Branch duct IPMN is less aggressive that the main duct variety, and may be conservatively followed. However, the development of an established indication for resection should prompt surgery. Despite generalized guidelines, decisions regarding management of pancreatic cysts should be individualized, accounting for the malignant risk of the lesion and the surgical risk of the patient. SN - 1532-1916 UR - https://www.unboundmedicine.com/medline/citation/19258185/Cystic_lesions_and_intraductal_neoplasms_of_the_pancreas_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1521-6918(08)00091-7 DB - PRIME DP - Unbound Medicine ER -