Pancreatic Cysts - Part 1: Using the American Gastroenterological Association Guidelines for the Management of Pancreatic Cysts—A Practical Approach
The recent publication of evidence-based guidelines by the American Gastroenterological Association for the management of the incidental pancreatic cyst has stimulated considerable discussion among clinicians and researchers. The guidelines examined the evidence in an accompanying technical review defining current diagnostic approaches, as well as cyst natural history. Recognizing that the risk of malignant degeneration of these cystic neoplasms has been overestimated, the guidelines boldly increased thresholds for endoscopic ultrasound imaging and cyst fluid sampling, as well as proposing a reduced frequency of surveillance compared with previous expert consensus recommendations. A practical approach to using these guidelines in daily clinical practice is discussed, emphasizing that an individualized approach is often required for this diverse and common clinical problem.