Diagnosis and Management of Pancreatic Cysts

Grace H. Elta, MD, FACG1, Brintha K. Enestvedt, MD, MBA2, Bryan G. Sauer, MD, MSc, FACG (GRADE Methodologist)3 and Anne Marie Lennon, MD, PhD, FACG4

1Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, Michigan, USA; 2Division of Gastroenterology, Oregon Health and Sciences University, Portland, Oregon, USA; 3Division of Gastroenterology, University of Virginia, Charlottesville, Virginia, USA; 4Division of Gastroenterology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

Am J Gastroenterol advance online publication 27 February 2018; doi: 10.1038/ajg.2018.14
Received 24 September 2017; accepted 5 January 2018

Correspondence: Grace H. Elta, MD, FACG, Division of Gastroenterology, University of Michigan Medical Center, 3912 Taubman Center, Michigan Medicine, Ann Arbor, Michigan 48109-5362, USA. E-mail: gelta@umich.edu


Pancreatic cysts are very common with the majority incidentally identified. There are several types of pancreatic cysts; some types can contain cancer or have malignant potential, whereas others are benign. However, even the types of cysts with malignant potential rarely progress to cancer. At the present time, the only viable treatment for pancreatic cysts is surgical excision, which is associated with a high morbidity and occasional mortality. The small risk of malignant transformation, the high risks of surgical treatment, and the lack of high-quality prospective studies have led to contradictory recommendations for their immediate management and for their surveillance. This guideline will provide a practical approach to pancreatic cyst management and recommendations for cyst surveillance for the general gastroenterologist.