Skip to main content
SpringerLink
Log in

Cystic Lesions of the Pancreas

  • Living reference work entry
  • First Online:
Geriatric Gastroenterology

Abstract

Pancreatic cystic lesions (PCLs) are commonly identified incidentally. Prevalence of PCLs increases with age and are therefore of specific importance to the geriatric population. Currently, the only definitive treatment for PCLs is surgical resection. Intraductal papillary mucinous neoplasms (IPMNs) are one of the most commonly encountered PCLs in clinical practice. Although the majority of IPMNs do not harbor invasive cancer when initially detected their malignant potential often creates a diagnostic and therapeutic dilemma. Before management decisions can be made, it is important to characterize a PCL using a combination of clinical and imaging features to assess the risk of incident or future malignancy. After a PCL has been appropriately characterized, some would warrant immediate surgical resection. In other PCLs, a management strategy ranging from no follow-up to periodic imaging surveillance must be implemented. If surgical resection is warranted, morbidity and mortality related to surgery and postoperative quality of life must be discussed with the patient to facilitate a shared decision. This chapter outlines the classification of PCLs and diagnostic and management approaches that will enable the reader to develop an evidence-based care plan for geriatric patients with PCLs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Abbreviations

CEA:

carcinoembryonic antigen

CT:

computed tomography

EUS:

endoscopic ultrasound

FNA:

fine needle aspiration

IPMN:

intraductal papillary mucinous neoplasm

MCN:

mucinous cystic neoplasm

MRCP:

magnetic resonance cholangiopancreatography

MRI:

magnetic resonance imaging

PCL:

pancreatic cystic lesion

PCN:

pancreatic cystic neoplasm

QOL:

quality of life

SCN:

serous cystic neoplasm

References

  • Adsay NV, Hasteh F, Cheng JD, Bejarano PA, Lauwers GY, Batts KP, et al. Lymphoepithelial cysts of the pancreas: a report of 12 cases and a review of the literature. Mod Pathol. 2002;15(5):492–501.

    Article  PubMed  Google Scholar 

  • Aslanian HR, Lee JH, Canto MIAGA. Clinical practice update on pancreas cancer screening in high-risk individuals: expert review. Gastroenterology. 2020;159(1):358–62.

    Article  CAS  PubMed  Google Scholar 

  • Assifi MM, Nguyen PD, Agrawal N, Dedania N, Kennedy EP, Sauter PK, et al. Non-neoplastic epithelial cysts of the pancreas: a rare, benign entity. J Gastrointest Surg. 2014;18(3):523–31.

    Article  PubMed  Google Scholar 

  • Augustin T, Burstein MD, Schneider EB, Morris-Stiff G, Wey J, Chalikonda S, et al. Frailty predicts risk of life-threatening complications and mortality after pancreatic resections. Surgery. 2016;160(4):987–96.

    Article  PubMed  Google Scholar 

  • Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis – 2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–11.

    Article  PubMed  Google Scholar 

  • Bergin D, Ho LM, Jowell PS, Pappas TN, Paulson EK. Simple pancreatic cysts: CT and endosonographic appearances. AJR Am J Roentgenol. 2002;178(4):837–40.

    Article  PubMed  Google Scholar 

  • Bergquist JR, Shubert CR, Ubl DS, Thiels CA, Kendrick ML, Truty MJ, et al. Risk by indication for pancreaticoduodenectomy in patients 80 years and older: a study from the American College of Surgeons National Surgical Quality Improvement Program. HPB. 2016;18(11):900–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.

    Article  PubMed  Google Scholar 

  • Brenner DJ, Hall EJ. Computed tomography – an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277–84.

    Article  CAS  PubMed  Google Scholar 

  • Brugge WR, Lauwers GY, Sahani D, Fernandez-del Castillo C, Warshaw AL. Cystic neoplasms of the pancreas. N Engl J Med. 2004a;351(12):1218–26.

    Article  CAS  PubMed  Google Scholar 

  • Brugge WR, Lewandrowski K, Lee-Lewandrowski E, Centeno BA, Szydlo T, Regan S, et al. Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study. Gastroenterology. 2004b;126(5):1330–6.

    Article  PubMed  Google Scholar 

  • Carboni F, Mancini P, Lorusso R, Santoro E. Solitary true cyst of the pancreas in adults. A report of two cases. J Pancreas. 2009;10(4):429–31.

    Google Scholar 

  • Casadei R, Ricci C, Lazzarini E, Taffurelli G, D’Ambra M, Mastroroberto M, et al. Pancreatic resection in patients 80 years or older: a meta-analysis and systematic review. Pancreas. 2014;43(8):1208–18.

    Article  PubMed  Google Scholar 

  • Chen Y-T, Ma F-H, Wang C-F, Zhao D-B, Zhang Y-W, Tian Y-T. Elderly patients had more severe postoperative complications after pancreatic resection: a retrospective analysis of 727 patients. World J Gastroenterol. 2018;24(7):844–51.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chernyak V, Flusberg M, Haramati LB, Rozenblit AM, Bellin E. Incidental pancreatic cystic lesions: is there a relationship with the development of pancreatic adenocarcinoma and all-cause mortality? Radiology. 2015;274(1):161–9.

    Article  PubMed  Google Scholar 

  • Choi SH, Park SH, Kim KW, Lee JY, Lee SS. Progression of unresected intraductal papillary mucinous neoplasms of the pancreas to cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2017;15(10):1509–20.e4.

    Article  PubMed  Google Scholar 

  • Cloyd JM, Tran Cao HS, Petzel MQ, Denbo JW, Parker NH, Nogueras-González GM, et al. Impact of pancreatectomy on long-term patient-reported symptoms and quality of life in recurrence-free survivors of pancreatic and periampullary neoplasms. J Surg Oncol. 2017;115(2):144–50.

    Article  PubMed  Google Scholar 

  • Correa-Gallego C, Ferrone CR, Thayer SP, Wargo JA, Warshaw AL, Fernández-Del Castillo C. Incidental pancreatic cysts: do we really know what we are watching? Pancreatology. 2010;10(2–3):144–50.

    Article  PubMed  PubMed Central  Google Scholar 

  • Crippa S, Salvia R, Warshaw AL, Domínguez I, Bassi C, Falconi M, et al. Mucinous cystic neoplasm of the pancreas is not an aggressive entity: lessons from 163 resected patients. Ann Surg. 2008;247(4):571–9.

    Article  PubMed  Google Scholar 

  • de Franco V, Frampas E, Wong M, Meurette G, Charvin M, Leborgne J, et al. Safety and feasibility of pancreaticoduodenectomy in the elderly: a matched study. Pancreas. 2011;40(6):920–4.

    Article  PubMed  Google Scholar 

  • de la Fuente J, Majumder S. Molecular diagnostics and testing for pancreatic cysts. Curr Treat Options Gastroenterol. 2020. PMID: 31989386. Online ahead of print.

    Google Scholar 

  • de Oliveira PB, Puchnick A, Szejnfeld J, Goldman SM. Prevalence of incidental pancreatic cysts on 3 tesla magnetic resonance. PLoS One. 2015;10(3):e0121317.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • de Pretis N, Mukewar S, Aryal-Khanal A, Bi Y, Takahashi N, Chari S. Pancreatic cysts: diagnostic accuracy and risk of inappropriate resections. Pancreatology. 2017;17(2):267–72.

    Article  PubMed  Google Scholar 

  • Del Chiaro M, Segersvärd R, Pozzi Mucelli R, Rangelova E, Kartalis N, Ansorge C, et al. Comparison of preoperative conference-based diagnosis with histology of cystic tumors of the pancreas. Ann Surg Oncol. 2014;21(5):1539–44.

    Article  PubMed  Google Scholar 

  • El Nakeeb A, Atef E, El Hanafy E, Salem A, Askar W, Ezzat H, et al. Outcomes of pancreaticoduodenectomy in elderly patients. Hepatobiliary Pancreat Dis Int. 2016;15(4):419–27.

    Article  PubMed  Google Scholar 

  • Elta GH, Enestvedt BK, Sauer BG, Lennon AM. ACG clinical guideline: diagnosis and management of pancreatic cysts. Am J Gastroenterol. 2018;113(4):464–79.

    Article  PubMed  Google Scholar 

  • Epelboym I, Winner M, DiNorcia J, Lee MK, Lee JA, Schrope B, et al. Quality of life in patients after total pancreatectomy is comparable with quality of life in patients who undergo a partial pancreatic resection. J Surg Res. 2014;187(1):189–96.

    Article  PubMed  Google Scholar 

  • European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut. 2018;67(5):789–804.

    Article  Google Scholar 

  • Faias S, Duarte M, Albuquerque C, da Silva JP, Fonseca R, Roque R, et al. Clinical impact of KRAS and GNAS analysis added to CEA and cytology in pancreatic cystic fluid obtained by EUS-FNA. Dig Dis Sci. 2018;63(9):2351–61.

    Article  CAS  PubMed  Google Scholar 

  • Ferrone CR, Correa-Gallego C, Warshaw AL, Brugge WR, Forcione DG, Thayer SP, et al. Current trends in pancreatic cystic neoplasms. Arch Surg. 2009;144(5):448–54.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fong ZV, Alvino DM, Castillo CF, Nipp RD, Traeger LN, Ruddy M, et al. Health-related quality of life and functional outcomes in 5-year survivors after pancreaticoduodenectomy. Ann Surg. 2017;266(4):685–92.

    Article  PubMed  Google Scholar 

  • Gardner TB, Glass LM, Smith KD, Ripple GH, Barth RJ, Klibansky DA, et al. Pancreatic cyst prevalence and the risk of mucin-producing adenocarcinoma in US adults. Am J Gastroenterol. 2013;108(10):1546–50.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gaujoux S, Brennan MF, Gonen M, D’Angelica MI, DeMatteo R, Fong Y, et al. Cystic lesions of the pancreas: changes in the presentation and management of 1,424 patients at a single institution over a 15-year time period. J Am Coll Surg. 2011;212(4):590–603.

    Article  PubMed  Google Scholar 

  • Gillis A, Cipollone I, Cousins G, Conlon K. Does EUS-FNA molecular analysis carry additional value when compared to cytology in the diagnosis of pancreatic cystic neoplasm? A systematic review. HPB. 2015;17(5):377–86.

    Article  PubMed  Google Scholar 

  • Goggins M, Overbeek KA, Brand R, Syngal S, Del Chiaro M, Bartsch DK, et al. Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium. Gut. 2020;69(1):7–17.

    Article  CAS  PubMed  Google Scholar 

  • Goh BK, Lin Z, Tan DM, Thng CH, Khor CJ, Lim TK, et al. Evaluation of the Fukuoka Consensus Guidelines for intraductal papillary mucinous neoplasms of the pancreas: results from a systematic review of 1,382 surgically resected patients. Surgery. 2015;158(5):1192–202.

    Article  PubMed  Google Scholar 

  • Gómez V, Takahashi N, Levy MJ, McGee KP, Jones A, Huang Y, et al. EUS-guided ethanol lavage does not reliably ablate pancreatic cystic neoplasms (with video). Gastrointest Endosc. 2016;83(5):914–20.

    Article  PubMed  Google Scholar 

  • Gruppo M, Tolin F, Franzato B, Pilati P, Spolverato YC, Zingales F, et al. Impact of age on short- and long-term outcomes after pancreatoduodenectomy for periampullary neoplasms. Gastroenterol Res Pract. 2020;2020:1–6.

    Article  Google Scholar 

  • Haigh PI, Bilimoria KY, DiFronzo LA. Early postoperative outcomes after pancreaticoduodenectomy in the elderly. Arch Surg. 2011;146(6):715–23.

    Article  CAS  PubMed  Google Scholar 

  • Hart PA, Chari ST. Management of pancreatic mucinous cystic neoplasms: surgery or surveillance? Pancreatology. 2015;15(2):97–8.

    Article  PubMed  Google Scholar 

  • Huang JJ, Yeo CJ, Sohn TA, Lillemoe KD, Sauter PK, Coleman J, et al. Quality of life and outcomes after pancreaticoduodenectomy. Ann Surg. 2000;231(6):890–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Huang P, Staerkel G, Sneige N, Gong Y. Fine-needle aspiration of pancreatic serous cystadenoma: cytologic features and diagnostic pitfalls. Cancer. 2006;108(4):239–49.

    Article  PubMed  Google Scholar 

  • Jais B, Rebours V, Malleo G, Salvia R, Fontana M, Maggino L, et al. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas). Gut. 2016;65(2):305–12.

    Article  CAS  PubMed  Google Scholar 

  • Johnson CD, Stephens DH, Charboneau JW, Carpenter HA, Welch TJ. Cystic pancreatic tumors: CT and sonographic assessment. AJR Am J Roentgenol. 1988;151(6):1133–8.

    Article  CAS  PubMed  Google Scholar 

  • Kimura W, Nagai H, Kuroda A, Muto T, Esaki Y. Analysis of small cystic lesions of the pancreas. Int J Pancreatol. 1995;18(3):197–206.

    Article  CAS  PubMed  Google Scholar 

  • Kneuertz PJ, Pitt HA, Bilimoria KY, Smiley JP, Cohen ME, Ko CY, et al. Risk of morbidity and mortality following hepato-pancreato-biliary surgery. J Gastrointest Surg. 2012;16(9):1727–35.

    Article  PubMed  Google Scholar 

  • Kromrey ML, Bülow R, Hübner J, Paperlein C, Lerch MM, Ittermann T, et al. Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study. Gut. 2018;67(1):138–45.

    Article  PubMed  Google Scholar 

  • Kulu Y, Schmied BM, Werner J, Muselli P, Büchler MW, Schmidt J. Total pancreatectomy for pancreatic cancer: indications and operative technique. HPB. 2009;11(6):469–75.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kwok K, Chang J, Duan L, Huang BZ, Wu BU. Competing risks for mortality in patients with asymptomatic pancreatic cystic neoplasms: implications for clinical management. Am J Gastroenterol. 2017;112(8):1330–6.

    Article  PubMed  Google Scholar 

  • Law JK, Ahmed A, Singh VK, Akshintala VS, Olson MT, Raman SP, et al. A systematic review of solid-pseudopapillary neoplasms: are these rare lesions? Pancreas. 2014;43(3):331–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee KS, Sekhar A, Rofsky NM, Pedrosa I. Prevalence of incidental pancreatic cysts in the adult population on MR imaging. Am J Gastroenterol. 2010;105(9):2079–84.

    Article  PubMed  Google Scholar 

  • Majumder S, Philip NA, Singh Nagpal SJ, Takahashi N, Mara KC, Kendrick ML, et al. High-grade dysplasia in resected Main-Duct Intraductal Papillary Mucinous Neoplasm (MD-IPMN) is associated with an increased risk of subsequent pancreatic cancer. Am J Gastroenterol. 2019;114(3):524–9.

    Article  PubMed  CAS  Google Scholar 

  • McWilliams RR, Maisonneuve P, Bamlet WR, Petersen GM, Li D, Risch HA, et al. Risk factors for early-onset and very-early-onset pancreatic adenocarcinoma: a Pancreatic Cancer Case-Control Consortium (PanC4) analysis. Pancreas. 2016;45(2):311–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Melis M, Marcon F, Masi A, Pinna A, Sarpel U, Miller G, et al. The safety of a pancreaticoduodenectomy in patients older than 80 years: risk vs. benefits. HPB. 2012;14(9):583–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meng L, Xia Q, Cai Y, Wang X, Li Y, Cai H, et al. Impact of patient age on morbidity and survival following laparoscopic pancreaticoduodenectomy. Surg Laparosc Endosc Percutan Tech. 2019;29(5):378–82.

    Article  PubMed  Google Scholar 

  • Morales-Oyarvide V, Mino-Kenudson M, Ferrone CR, Gonzalez-Gonzalez LA, Warshaw AL, Lillemoe KD, et al. Acute pancreatitis in intraductal papillary mucinous neoplasms: a common predictor of malignant intestinal subtype. Surgery. 2015;158(5):1219–25.

    Article  PubMed  Google Scholar 

  • Moris M, Bridges MD, Pooley RA, Raimondo M, Woodward TA, Stauffer JA, et al. Association between advances in high-resolution cross-section imaging technologies and increase in prevalence of pancreatic cysts from 2005 to 2014. Clin Gastroenterol Hepatol. 2016a;14(4):585–93.e3.

    Article  PubMed  Google Scholar 

  • Moris M, Raimondo M, Woodward TA, Skinner V, Arcidiacono PG, Petrone MC, et al. Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration cytology, carcinoembryonic antigen, and amylase in intraductal papillary mucinous neoplasm. Pancreas. 2016b;45(6):870–5.

    Article  CAS  PubMed  Google Scholar 

  • Morris-Stiff G, Falk GA, Chalikonda S, Walsh RM. Natural history of asymptomatic pancreatic cystic neoplasms. HPB. 2013;15(3):175–81.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mukewar S, de Pretis N, Aryal-Khanal A, Ahmed N, Sah R, Enders F, et al. Fukuoka criteria accurately predict risk for adverse outcomes during follow-up of pancreatic cysts presumed to be intraductal papillary mucinous neoplasms. Gut. 2017;66(10):1811–7.

    Article  PubMed  Google Scholar 

  • Nadig SN, Pedrosa I, Goldsmith JD, Callery MP, Vollmer CM. Clinical implications of mucinous nonneoplastic cysts of the pancreas. Pancreas. 2012;41(3):441–6.

    Article  PubMed  Google Scholar 

  • Nasr J, Sanders M, Fasanella K, Khalid A, McGrath K. Lymphoepithelial cysts of the pancreas: an EUS case series. Gastrointest Endosc. 2008;68(1):170–3.

    Article  PubMed  Google Scholar 

  • National Cancer Institute (NCI). Cancer stat facts: pancreatic cancer. 2020. Available at: https://seer.cancer.gov/statfacts/html/pancreas.html. Accessed 10 Aug 2020.

  • Okabayashi T, Shima Y, Iwata J, Morita S, Sumiyoshi T, Kozuki A, et al. Is a surgical approach justified for octogenarians with pancreatic carcinoma? Projecting surgical decision making for octogenarian patients. Am J Surg. 2016;212(5):896–902.

    Article  PubMed  Google Scholar 

  • Oliveira-Cunha M, Malde DJ, Aldouri A, Morris-Stiff G, Menon KV, Smith AM. Results of pancreatic surgery in the elderly: is age a barrier? HPB. 2013;15(1):24–30.

    Article  PubMed  Google Scholar 

  • Oyama H, Tada M, Takagi K, Tateishi K, Hamada T, Nakai Y, et al. Long-term risk of malignancy in branch-duct intraductal papillary mucinous neoplasms. Gastroenterology. 2020;158(1):226–37.e5.

    Article  CAS  PubMed  Google Scholar 

  • Paiella S, De Pastena M, Pollini T, Zancan G, Ciprani D, De Marchi G, et al. Pancreaticoduodenectomy in patients ≥75 years of age: are there any differences with other age ranges in oncological and surgical outcomes? Results from a tertiary referral center. World J Gastroenterol. 2017;23(17):3077–83.

    Article  PubMed  PubMed Central  Google Scholar 

  • Park JW, Jang JY, Kang MJ, Kwon W, Chang YR, Kim SW. Mucinous cystic neoplasm of the pancreas: is surgical resection recommended for all surgically fit patients? Pancreatology. 2014;14(2):131–6.

    Article  PubMed  Google Scholar 

  • Pędziwiatr M, Małczak P, Mizera M, Witowski J, Torbicz G, Major P, et al. Pancreatoduodenectomy for pancreatic head tumors in the elderly – systematic review and meta-analysis. Surg Oncol. 2018;27(3):346–64.

    Article  PubMed  Google Scholar 

  • Pelletier AL, Hammel P, Rebours V, Couvelard A, Vullierme MP, Maire F, et al. Acute pancreatitis in patients operated on for intraductal papillary mucinous neoplasms of the pancreas: frequency, severity, and clinicopathologic correlations. Pancreas. 2010;39(5):658–61.

    Article  PubMed  Google Scholar 

  • Puri PM, Watkins AA, Kent TS, Maggino L, Jeganathan JG, Callery MP, et al. Decision-making for the management of cystic lesions of the pancreas: how satisfied are patients with surgery? J Gastrointest Surg. 2018;22(1):88–97.

    Article  PubMed  Google Scholar 

  • Ramanathan R, Al Abbas AI, Mason T, Wolfe LG, Kaplan BJ. Age-related risks of complications after distal pancreatectomy for neuroendocrine and cystic neoplasms. HPB. 2019;21(7):810–7.

    Article  PubMed  Google Scholar 

  • Reid MD, Choi HJ, Memis B, Krasinskas AM, Jang KT, Akkas G, et al. Serous neoplasms of the pancreas: a clinicopathologic analysis of 193 cases and literature review with new insights on macrocystic and solid variants and critical reappraisal of so-called “serous cystadenocarcinoma”. Am J Surg Pathol. 2015;39(12):1597–610.

    Article  PubMed  Google Scholar 

  • Riall TS. What is the effect of age on pancreatic resection? Adv Surg. 2009;43:233–49.

    Article  PubMed  PubMed Central  Google Scholar 

  • Riall TS, Reddy DM, Nealon WH, Goodwin JS. The effect of age on short-term outcomes after pancreatic resection: a population-based study. Ann Surg. 2008;248(3):459–67.

    Article  PubMed  Google Scholar 

  • Ridtitid W, DeWitt JM, Schmidt CM, Roch A, Stuart JS, Sherman S, et al. Management of branch-duct intraductal papillary mucinous neoplasms: a large single-center study to assess predictors of malignancy and long-term outcomes. Gastrointest Endosc. 2016;84(3):436–45.

    Article  PubMed  Google Scholar 

  • Sahora K, Ferrone CR, Brugge WR, Morales-Oyarvide V, Warshaw AL, Lillemoe KD, et al. Effects of comorbidities on outcomes of patients with intraductal papillary mucinous neoplasms. Clin Gastroenterol Hepatol. 2015;13(10):1816–23.

    Article  PubMed  Google Scholar 

  • Salvia R, Malleo G, Marchegiani G, Pennacchio S, Paiella S, Paini M, et al. Pancreatic resections for cystic neoplasms: from the surgeon’s presumption to the pathologist’s reality. Surgery. 2012;152(3 Suppl 1):S135–42.

    Article  PubMed  Google Scholar 

  • Scheiman JM, Hwang JH, Moayyedi P. American gastroenterological association technical review on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology. 2015;148(4):824–48.e22.

    Article  PubMed  Google Scholar 

  • Schmidt CM, Turrini O, Parikh P, House MG, Zyromski NJ, Nakeeb A, et al. Effect of hospital volume, surgeon experience, and surgeon volume on patient outcomes after pancreaticoduodenectomy: a single-institution experience. Arch Surg. 2010;145(7):634–40.

    Article  PubMed  Google Scholar 

  • Shah KP, Baugh KA, Brubaker LS, Van Buren G II, Villafane-Ferriol N, McElhany AL, et al. Long-term assessment of pancreatic function after pancreatectomy for cystic neoplasms. J Surg Res. 2020;247:547–55.

    Article  PubMed  Google Scholar 

  • Shamali A, De’Ath HD, Jaber B, Abuawad M, Barbaro S, Hamaday Z, et al. Elderly patients have similar short term outcomes and five-year survival compared to younger patients after pancreaticoduodenectomy. Int J Surg. 2017;45:138–43.

    Article  PubMed  Google Scholar 

  • Shin SH, Han DJ, Park KT, Kim YH, Park JB, Kim SC. Validating a simple scoring system to predict malignancy and invasiveness of intraductal papillary mucinous neoplasms of the pancreas. World J Surg. 2010;34(4):776–83.

    Article  PubMed  Google Scholar 

  • Shubert CR, Kendrick ML, Thomsen KM, Farnell MB, Habermann EB. Identification of risk categories for in pancreaticoduodenectomy based on diagnosis. HPB. 2015;17(5):428–37.

    Article  PubMed  Google Scholar 

  • Singhi AD, Zeh HJ, Brand RE, Nikiforova MN, Chennat JS, Fasanella KE, et al. American Gastroenterological Association guidelines are inaccurate in detecting pancreatic cysts with advanced neoplasia: a clinicopathologic study of 225 patients with supporting molecular data. Gastrointest Endosc. 2016;83(6):1107–17.e2.

    Article  PubMed  Google Scholar 

  • Singhi AD, McGrath K, Brand RE, Khalid A, Zeh HJ, Chennat JS, et al. Preoperative next-generation sequencing of pancreatic cyst fluid is highly accurate in cyst classification and detection of advanced neoplasia. Gut. 2018;67(12):2131.

    Article  CAS  PubMed  Google Scholar 

  • Smith-Bindman R, Miglioretti DL, Larson EB. Rising use of diagnostic medical imaging in a large integrated health system. Health Aff. 2008;27(6):1491–502.

    Article  Google Scholar 

  • Sperti C, Moletta L, Pozza G. Pancreatic resection in very elderly patients: a critical analysis of existing evidence. World J Gastrointest Oncol. 2017;9(1):30–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Springer S, Wang Y, Dal Molin M, Masica DL, Jiao Y, Kinde I, et al. A combination of molecular markers and clinical features improve the classification of pancreatic cysts. Gastroenterology. 2015;149(6):1501–10.

    Article  CAS  PubMed  Google Scholar 

  • Sukharamwala P, Thoens J, Szuchmacher M, Smith J, DeVito P. Advanced age is a risk factor for post-operative complications and mortality after a pancreaticoduodenectomy: a meta-analysis and systematic review. HPB. 2012;14(10):649–57.

    Article  PubMed  Google Scholar 

  • Tanaka M, Fernández-Del Castillo C, Kamisawa T, Jang JY, Levy P, Ohtsuka T, et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 2017;17(5):738–53.

    Article  PubMed  Google Scholar 

  • Valsangkar NP, Morales-Oyarvide V, Thayer SP, Ferrone CR, Wargo JA, Warshaw AL, et al. 851 Resected cystic tumors of the pancreas: a 33-year experience at the Massachusetts General Hospital. Surgery. 2012;152(3 Suppl 1):S4–12.

    Article  PubMed  Google Scholar 

  • van der Gaag NA, Berkhemer OA, Sprangers MA, Busch OR, Bruno MJ, de Castro SM, et al. Quality of life and functional outcome after resection of pancreatic cystic neoplasm. Pancreas. 2014;43(5):755–61.

    Article  PubMed  Google Scholar 

  • Vege SS, Ziring B, Jain R, Moayyedi P. American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts. Gastroenterology. 2015;148(4):819–22. Quize12–3.

    Article  PubMed  Google Scholar 

  • Zakaria HM, Stauffer JA, Raimondo M, Woodward TA, Wallace MB, Asbun HJ. Total pancreatectomy: short- and long-term outcomes at a high-volume pancreas center. World J Gastrointest Surg. 2016;8(9):634–42.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zerboni G, Signoretti M, Crippa S, Falconi M, Arcidiacono PG, Capurso G. Systematic review and meta-analysis: prevalence of incidentally detected pancreatic cystic lesions in asymptomatic individuals. Pancreatology. 2019;19(1):2–9.

    Article  PubMed  Google Scholar 

  • Zhu S, Wang W-T, Shang X-S, Ni T, Wu W-C, Lou W-H, et al. Difference analysis in prevalence of incidental pancreatic cystic lesions between computed tomography and magnetic resonance imaging. BMC Med Imaging. 2019;19(1):43.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Sciences, Rochester, MN, USA

    Jaime de la Fuente & Shounak Majumder

Authors
  1. Jaime de la Fuente
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shounak Majumder
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shounak Majumder .

Editor information

Editors and Affiliations

  1. Saint Peter's Healthcare System, New Brunswick, NJ, USA

    C. S. Pitchumoni

  2. Albert Einstein College of Medicine, Montefiore Medical Center, Wakefield Campus, Bronx, NY, USA

    T.S. Dharmarajan

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

de la Fuente, J., Majumder, S. (2021). Cystic Lesions of the Pancreas. In: Pitchumoni, C.S., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-319-90761-1_113-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-90761-1_113-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90761-1

  • Online ISBN: 978-3-319-90761-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation