Publication: Current status on the diagnosis and management of pancreatic cysts in the Asia-Pacific region: Role of endoscopic ultrasound
Issued Date
2011-01-01
Resource Type
ISSN
14401746
08159319
08159319
Other identifier(s)
2-s2.0-81855206327
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Gastroenterology and Hepatology (Australia). Vol.26, No.12 (2011), 1702-1708
Suggested Citation
Lee Guan Lim, Takao Itoi, Wee Chian Lim, Steven Joseph Mesenas, Dong Wan Seo, Jonard Tan, Hsiu Po Wang, Thawatchai Akaraviputh, Sandeep Lakhtakia, Salem Omar, Thawee Rantachu, Sharmila Sachitanandan, Kenjiro Yasuda, Shyam Varadarajulu, Jennie Wong, Vinay Dhir, Khek Yu Ho Current status on the diagnosis and management of pancreatic cysts in the Asia-Pacific region: Role of endoscopic ultrasound. Journal of Gastroenterology and Hepatology (Australia). Vol.26, No.12 (2011), 1702-1708. doi:10.1111/j.1440-1746.2011.06884.x Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/12782
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Title
Current status on the diagnosis and management of pancreatic cysts in the Asia-Pacific region: Role of endoscopic ultrasound
Other Contributor(s)
National University Health System
National University of Singapore
Yong Loo Lin School of Medicine
Tokyo Medical University
Kyoto Daini Sekijyuji Byoin
University of Ulsan, College of Medicine
St Luke's Medical Center-Bonifacio Global City
National Taiwan University Hospital
Mahidol University
Rajavithi Hospital
Asian Institute of Gastroenterology India
University of Malaya
Sime Darby Healthcare
University of Alabama
Institute of Advanced Endoscopy
S.L. Raheja Hospital (A Fortis Associate)
National University of Singapore
Yong Loo Lin School of Medicine
Tokyo Medical University
Kyoto Daini Sekijyuji Byoin
University of Ulsan, College of Medicine
St Luke's Medical Center-Bonifacio Global City
National Taiwan University Hospital
Mahidol University
Rajavithi Hospital
Asian Institute of Gastroenterology India
University of Malaya
Sime Darby Healthcare
University of Alabama
Institute of Advanced Endoscopy
S.L. Raheja Hospital (A Fortis Associate)
Abstract
Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) play increasingly prominent roles in the diagnosis and management of pancreatic cysts. The Asian Consortium of Endoscopic Ultrasound was recently formed to conduct collaborative research in this area. This is a review of literature on true pancreatic cysts. Due to the lack of systematic studies, there are no robust data on the true incidence of pancreatic cystic lesions in Asia and any change in over the recent decades. Certain EUS morphological features have been used to predict particular types of pancreatic cysts. Pancreatic cyst fluid viscosity, cytology, pancreatic enzymes, and tumor markers, in particular carcinoembryonic antigen, can aid in the diagnosis of pancreatic cysts. Hemorrhage and infection are the most common complications of EUS-FNA of pancreatic cysts. Pancreatic cysts can either be observed or resected depending on the benign or malignant nature, or malignant potential of the lesions. Guidelines from an international consensus did not require positive cytological findings to be present in their recommendation for resection, which included all mucinous cystic neoplasms, all main-duct intraductal papillary mucinous neoplasms (IPMN), all mixed IPMN, symptomatic side-branch IPMN, and side-branch IPMN larger than 3cm. In patients with poor surgical risks, EUS-guided cyst ablation of mucinous pancreatic cysts is an alternative. As long-term prospective data on pancreatic cysts are still not available in Asia, management strategies are largely based on risk stratification by surgical risk and malignant potential. Gene expression profiling of pancreatic cyst fluid and confocal laser endomicroscopic examination of pancreatic cysts are novel techniques currently being studied. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.