Clinical Journal of Gastroenterology

, Volume 12, Issue 2, pp 93–101 | Cite as

Current indications and yield of endoscopic ultrasound and ancillary techniques in pancreatic cystic neoplasms

  • Federico SalomEmail author
  • Frédéric Prat
Clinical Review


An increase in the diagnosis of pancreatic cystic neoplasm has been described lately. Surgical treatment or surveillance is advised depending on the type of lesion diagnosed. The most accurate diagnostic approach is needed to make the best therapeutic decision. Endoscopic ultrasound is a very valuable tool in the evaluation of pancreatic cystic neoplasm. It generates high-quality images and allows the possibility of sampling the cystic fluid for cytology, microbiological and molecular evaluation. Even with this evaluation, the sensitivity of this approach is not always adequate. New technological resources have been developed to try to improve the diagnostic accuracy of pancreatic cystic neoplasms. The two most promising techniques are needle-based confocal laser endomicroscopy and contrast-enhanced harmonic endoscopic ultrasound. Needle-based confocal laser endomicroscopy allows a microscopic evaluation of mucosal glands and vascular pattern, to differentiate mucinous from non-mucinous lesions. Contrast-enhanced harmonic endoscopic ultrasound is used for the vascular evaluation of the microcirculation of the cyst wall and mural nodule, mainly to make the difference between malignant nodules and mucus plugs. A combination of these different diagnostic techniques can improve the diagnostic accuracy of pancreatic cystic neoplasms to offer the adequate therapeutic decision.


Pancreatic cystic neoplasm Endoscopic ultrasound Fine-needle aspiration Endomicroscopy Contrast-enhanced harmonic endoscopic ultrasound 



The authors disclose no financial relationships or conflict of interest relevant to this publication.


None declared.

Compliance with ethical standards

Conflict of interest

Federico Salom and Frédéric Prat declare that they have no conflict of interest.

Human/animal rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

The study did not involve human subjects so no informed consent was obtained.


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© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Departamento de GastroenterologíaHospital MéxicoSan JoséCosta Rica
  2. 2.Service de Gastroenterologie, d’endoscopie et de Cancerologie DigestiveAPHP-Hopital CochinParisFrance

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