Pancreatic Cysts in the Elderly

  • Luis F. LaraEmail author
  • Anjuli Luthra
  • Darwin L. Conwell
  • Somashekar G. Krishna
Gastroenterology for Geriatric Patients (S Katz and A Afzali, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Gastroenterology for Geriatric Patients


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.

Recent findings

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.


Pancreatic cysts Mucinous cysts Cyst diagnosis Cyst management Cyst treatment 



Pancreatic cystic lesions


Computed tomography


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


Carcinoembryonic antigen


Next-generation sequencing


Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy


Charlson Comorbidity Index


The Ohio State University Wexner Medical Center


Multidisciplinary Board


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


von Hippel-Lindau


Years old


Author contribution

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.

Funding information

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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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Luis F. Lara
    • 1
    Email author
  • Anjuli Luthra
    • 1
  • Darwin L. Conwell
    • 1
  • Somashekar G. Krishna
    • 1
  1. 1.Division of Gastroenterology, Hepatology and NutritionThe Ohio State University Wexner Medical CenterColumbusUSA

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