ASGE Annual Postgraduate Course Endoscopy 2022: Breakthrough to Excellence | DDW 2022-Shami_Approach to PCs Navigating the Algorithm Maze

Shami_Approach to PCs Navigating the Algorithm Maze

Pdf Summary

This document discusses the approach to pancreatic cysts and the various guidelines for their management. Pancreatic cysts can be pre-malignant, with some having the potential to become cancerous. Different guidelines have been developed to help identify which cysts are at risk for malignancy. The timeline of these guidelines is outlined, including the Fukuoka, AGA, ACG, and European guidelines.<br /><br />Before determining the management approach, certain concepts are considered "no brainers." These include symptomatic cysts and those associated with a mass. Surveillance is only considered if the patient is a surgical candidate and willing to undergo surgery or systemic therapy.<br /><br />The document also discusses specific types of pancreatic cysts, such as mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). It highlights the criticisms and controversies surrounding the different guidelines, including their surveillance intervals and lack of mention of when to stop surveillance.<br /><br />The guidelines do not take into consideration fluid aspiration results or molecular markers, which could provide additional information for risk assessment. A Monte Carlo cost analysis shows the estimated costs and outcomes of different imaging and surgical procedures for pancreatic cysts.<br /><br />In conclusion, the document emphasizes the importance of using both clinical judgment and guidelines in the management of pancreatic cysts. It also highlights the criteria for surveillance and the importance of evaluating for surgery based on certain factors. Despite differences and controversies, the guidelines suggest a similar approach to the management of pancreatic cysts.

Keywords

pancreatic cysts

management

pre-malignant

guidelines

surveillance

surgical candidate

MCN

IPMN

controversies

risk assessment