Diagnosis and Management of Pancreatic Cysts: A Comprehensive Review of the Literature

The prevalence of pancreatic cysts has been rising due to the widespread use of cross-sectional imaging (CT scan and MRI) of the abdomen. While most pancreatic cysts are benign and do not require treatment or surveillance, a significant minority are premalignant and rarely malignant. The risk stratification of these lesions is not straightforward, and individual risk assessment, cyst size, distribution, and alarming morphologic features (when present) can guide the next steps in management. Neoplastic pancreatic cysts are mucinous or non-mucinous. Endoscopic ultrasound with fine-needle aspiration is often required to classify pancreatic cysts into mucinous and non-mucinous cysts and to assess the malignant potential. Advances in endoscopic techniques (confocal laser endomicroscopy, microforceps biopsy) can provide a definitive diagnosis of pancreatic cysts in some cases; however, the use of these techniques involves a higher risk of adverse events.

Automated summary

The prevalence of pancreatic cysts is increasing due to the widespread use of cross-sectional imaging. Risk stratification of these lesions is not straightforward, and individual risk assessment as well as cyst size, distribution, and morphologic features can guide management decisions. Endoscopic ultrasound with fine-needle aspiration is often required to classify pancreatic cysts and assess malignant potential. Advances in endoscopic techniques can provide a definitive diagnosis, but carry higher risks of adverse events.