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Endoscopic Ultrasound pp 299–327Cite as

The Role of EUS in Cystic Lesions of the Pancreas

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Part of the book series: Clinical Gastroenterology ((CG))

Abstract

Cystic pancreatic lesions (CPLs) are increasingly recognized in clinical practice. Although inflammatory cysts are most commonly encountered, mucinous CPLs are important to identify and follow due to the risk of progression to malignancy. Endoscopic ultrasound (EUS) is widely accepted as the test of choice for the diagnosis and follow-up of CPLs. Not only does EUS permit close high quality images of the cyst, but also allows for fine needle aspiration (FNA) of cyst fluid, where cytological exam is performed to determine malignancy. More recently, certain tumor markers and DNA analysis of genetic markers of cyst fluid became available and could help differentiate mucinous from nonmucinous lesions. Management of CPLs takes into account the risk of malignancy and the benefit of pancreatic resection. This decision usually depends on multiple factors, including the type of cyst, presence of clinical symptoms, suspected underlying malignancy, and patient’s overall health status. Recent development of minimally invasive treatment alternatives like cyst epithelium ablation with alcohol, appear safe and effective in high risk lesions although larger long-term studies are needed to demonstrate clinical utility.

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Authors and Affiliations

  1. Division of Gastroenterology & Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA

    Mohammad Al-Haddad MD (Assistant Professor of Clinical Medicine) & John DeWitt MD, FASGE, FACP (Associate Professor of Clinical Medicine)

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  1. Mohammad Al-Haddad MD
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  2. John DeWitt MD, FASGE, FACP
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Editors and Affiliations

  1. Digestive Health Center, University of Virginia Health System, Charlottesville, VA, USA

    Vanessa M. Shami MD (Associate Professor of Medicine Director of Endoscopic Ultrasound) (Associate Professor of Medicine Director of Endoscopic Ultrasound)

  2. Digestive Health Center, University of Virginia Helath System, Charlottesville, USA

    Michel Kahaleh MD (Associate Professor of Medicine Director of Pancreatico-Biliary Services) (Associate Professor of Medicine Director of Pancreatico-Biliary Services)

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Al-Haddad, M., DeWitt, J. (2010). The Role of EUS in Cystic Lesions of the Pancreas. In: Shami, V.M., Kahaleh, M. (eds) Endoscopic Ultrasound. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-480-7_13

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  • DOI: https://doi.org/10.1007/978-1-60327-480-7_13

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-479-1

  • Online ISBN: 978-1-60327-480-7

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