| Abstract [eng] |
Due to advancements in imaging technologies, increased accessibility, and an aging population, pancreatic cysts are increasingly detected as incidental findings during investigations for other or unexplained abdominal pathologies. These cysts have a heterogeneous clinical course and display a varying degree of malignancy – from benign lesions to malignant carcinomas. Although most of these lesions do not pose a direct threat to the patient, unidentified cysts can become a source of significant concern, considering that even benign cysts may progress to cancerous cysts over time. Differentiation of malignant cysts relies on imaging studies and cytomorphological differentiation between mucinous and non-mucinous cysts, often performed via fine-needle aspiration under 4 endoscopic ultrasound guidance. In the analysis of intracystic fluid, new and promising biomarkers are being explored to facilitate diagnosis. Emerging techniques such as confocal laser endomicroscopy and positron emission tomography show potential but are currently accompanied by limited recommendations in clinical guidelines. The treatment of pancreatic cysts primarily involves surgical resection, but endoscopic ablation techniques are increasingly being considered for non-operable patients. For these patients, surveillance is often recommended in literature, however, guidelines provide conflicting recommendations, emphasizing the need for an individualized approach to cyst follow-up. The ending of long-term surveillance remains a controversial topic, showing the need for updated, unified, and evidence-based guidelines. |
