Management of pancreatic cysts and guidelines: what the gastroenterologist needs to know

The prevalence of pancreatic cysts has increased significantly over the last decade, partly secondary to quality and frequency cross-sectional imaging. While majority never progress cancer, a small number will need be followed. management can both confusing intimidating due multiple guidelines with varying recommendations. Despite differences in specifics guidelines, they all agree on several high-risk features that should get attention any clinician when assessing cyst: presence mural nodule or solid component, dilation main duct (or intraductal papillary mucinous neoplasm), cyst size ⩾3–4 cm, positive cytology fluid aspiration. Other important criteria consider include rapid growth (⩾5 mm/year), elevated serum carbohydrate antigen 19-9 levels, new-onset diabetes mellitus, acute pancreatitis thought related cystic lesion.