Journal article
Comparison of Society Guidelines for the Management and Surveillance of Pancreatic Cysts A Review
JAMA surgery, Vol.157(8), pp.723-730
08/01/2022
DOI: 10.1001/jamasurg.2022.2232
PMID: 35731507
Abstract
IMPORTANCE The identification of incidental pancreas cystic lesions (PCLs) has increased in recent decades with the expanded use and improved sensitivity of cross-sectional imaging. Because the overall risk of malignancy associated with PCLs is low, yet the relative morbidity of pancreatic surgery is high, evidence-based guidelines are necessary for appropriate surveillance and management. Therefore, this article provides a review of existing guidelines regarding surveillance and management of PCLs and highlights recent advances in the diagnostic evaluation of cysts and the postresection management of mucinous lesions.
OBSERVATIONS There are 5 main guidelines related to the management of PCLs: the American Gastrointestinal Association (AGA) guidelines, the American College of Gastroenterology (ACG) guidelines, the American College of Radiology (ACR) recommendations, the European evidence-based guidelines, and the International Association of Pancreatology (IAP)/Fukuoka guidelines. These guidelines are based on retrospective studies that do not account or control for most tumor- and patient-specific factors. These guidelines also vary in scope, recommendations for surgical resection vs surveillance, as well as duration and type of follow-up.
CONCLUSIONS AND RELEVANCE PCL guidelines should be viewed within the context of the data limitations on which they are based. PCL subtype-specific guidelines on surveillance and treatment are needed. In the future, the integration of cyst-specific genomic analysis, as well as evolutions in advanced diagnostic tools, such as cyst fluid next-generation sequencing and EUS-guided confocal laser endomicroscopy, may also better inform treatment guidelines. Owing to the current low-quality evidence on which many guidelines are based and the inherent morbidity of pancreas surgery, it is imperative that patients with PCLs are referred to institutions with advanced diagnostics and a multidisciplinary approach to patient surveillance and management.
Details
- Title: Subtitle
- Comparison of Society Guidelines for the Management and Surveillance of Pancreatic Cysts A Review
- Creators
- Hassan Aziz - Tufts Medical CenterAlexandra W. Acher - University of Utah HospitalSomashekar G. Krishna - The Ohio State University Wexner Medical CenterJordan M. Cloyd - The Ohio State University Wexner Medical CenterTimothy M. Pawlik - The Ohio State University Wexner Medical Center
- Resource Type
- Journal article
- Publication Details
- JAMA surgery, Vol.157(8), pp.723-730
- Publisher
- Amer Medical Assoc
- DOI
- 10.1001/jamasurg.2022.2232
- PMID
- 35731507
- ISSN
- 2168-6254
- eISSN
- 2168-6262
- Number of pages
- 8
- Language
- English
- Date published
- 08/01/2022
- Academic Unit
- Surgery
- Record Identifier
- 9984701551602771
Metrics
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