Pancreatic Cysts in the Elderly
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Purpose of review
Incidental pancreatic cysts are common, and management strategies continue to evolve. This review summarizes diagnostic and management recommendations in older patients with these lesions based on guidelines and best clinical evidence.
Diagnosis of cyst type has been enhanced with improved imaging and cyst fluid analysis and visualization. Recent outcome studies indicate that certain cyst types should be followed independent of patient age as long as certain criteria which are reviewed are met.
Differentiation of pancreatic cyst type is important as this dictates the need for long-term follow-up. Because most cyst-related neoplasia occurs in older patients, surveillance should continue within certain guidelines.
KeywordsPancreatic cysts Mucinous cysts Cyst diagnosis Cyst management Cyst treatment
Pancreatic cystic lesions
Magnetic resonance imaging
pancreatic ductal adenocarcinoma
Intraductal papillary mucinous neoplasm
Mucinous cystic neoplasm
Branch-duct intraductal papillary mucinous neoplasm
Endoscopic ultrasound-guided fine-needle aspiration
American Gastroenterological Association
American College of Radiology
Magnetic resonance cholangiopancreatography
Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy
Charlson Comorbidity Index
The Ohio State University Wexner Medical Center
Kirsten rat sarcoma viral oncogene homolog
Guanine nucleotide binding protein, alpha stimulating
Tumor protein p53
Phosphoinositide 3-kinase, catalytic, alpha polypeptide
Phosphatase and tensin
Cyclin-dependent kinase Inhibitor 2A
Drosophila protein, mothers against decapentaplegic (Mad), and the Caenorhabditis elegans protein (Sma) homolog 4
Luis F. Lara, MD, and Somashekar G. Krishna, MD, MPH, studied concept and design and drafted, wrote, and reviewed manuscript. Anjuli Luthra, MD, and Darwin L. Conwell, MD, MS, studied concept design and wrote and reviewed the manuscript.
Luis F. Lara: none. The companies mentioned in the funding (Covidien, Abbvie, Allergan) should go to conflict of interest for author Luis F. Lara
Compliance with ethical standards
Conflict of interest
Somashekar Krishna reports grant funding for a prospective study (currently recruiting patients) from Mauna Kea Technologies.
Luis Lara declares no conflict of interest.
Anjuli Luthra declares no conflict of interest.
Darwin L. Conwell declares no conflict of interest.
Human and animal rights and informed consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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