Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Endoscopic diagnosis of pancreatic cysts

Blaszczak, Alecia M.a; Krishna, Somashekar G.b,c

Current Opinion in Gastroenterology: September 2019 - Volume 35 - Issue 5 - p 448–454
doi: 10.1097/MOG.0000000000000558
PANCREAS: Edited by Timothy B. Gardner
Buy

Purpose of review Pancreatic cystic lesions (PCLs) are increasingly identified on abdominal imaging. Given the malignant potential of certain cyst subtypes and the poor survival rates of pancreatic cancer, accurate diagnosis and appropriate management of these cysts are critical.

Recent findings Advances in endoscopic ultrasound (EUS)-guided diagnostics have increased the accuracy of differentiating PCLs. These include cyst fluid molecular analysis, EUS-guided needle-based confocal laser endomicroscopy, and EUS-guided through the needle microforceps biopsy. This review encapsulates recent advances in the endoscopic management of PCLs with a specific focus on EUS-guided diagnosis.

Summary It is important to accurately diagnose pancreatic cystic lesions with malignant potential where the definitive management is surgical resection. Misdiagnosis can result in inadvertent surgery of an otherwise benign lesion or malignant progression of a precancerous cyst. Moreover, pancreatic surgery is associated with significant morbidity and mortality. Recent advances in EUS-guided tissue acquisition, imaging, and molecular biomarkers have resulted in improved diagnostic accuracy of pancreatic cystic lesions. Future studies need to define efficient and accurate diagnostic algorithms for improved management of pancreatic cysts.

aThe Ohio State University College of Medicine

bSections of Pancreatic disorders and Advanced Endoscopy, Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center

cThe Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, Ohio, USA

Correspondence to Somashekar G. Krishna, MD, MPH, Associate Professor of Medicine, Sections of Pancreatic disorders and Advanced Endoscopy, Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, 395W. 12th Avenue Columbus, OH 43210, USA. Tel: +1 614 293 6255; e-mail: somashekar.krishna@osumc.edu

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.