European evidence-based guidelines on pancreatic cystic neoplasms. Issue 5 (24th March 2018)

• Record Type: Journal Article
• Other Names: Del Chiaro Marco author non-byline.; Besselink Marc author non-byline.; Scholten Lianne author non-byline.; Bruno Marco J author non-byline.; Cahen Djuna L author non-byline.; Gress Thomas M author non-byline.; van Hooft Jeanin E author non-byline.; Lerch Markus M author non-byline.; Mayerle Julia author non-byline.; Hackert Thilo author non-byline.; Satoi Sohei author non-byline.; Zerbi Alessandro author non-byline.; Cunningham David author non-byline.; Angelis Claudio De author non-byline.; Giovannini Marc author non-byline.; De-Madaria Enrique author non-byline.; Hegyi Peter author non-byline.; Rosendahl Jonas author non-byline.; Friess Helmut author non-byline.; Manfredi Riccardo author non-byline.; Lévy Philippe author non-byline.; Real Francisco X author non-byline.; Sauvanet Alain author non-byline.; Abu Hilal Mohammed author non-byline.; Marchegiani Giovanni author non-byline.; Esposito Irene author non-byline.; Ghaneh Paula author non-byline.; Engelbrecht Marc RW author non-byline.; Fockens Paul author non-byline.; van Huijgevoort Nadine CM author non-byline.; Wolfgang Christopher author non-byline.; Bassi Claudio author non-byline.; Gubergrits Natalya B author non-byline.; Verbeke Caroline author non-byline.; Klöppel Günter author non-byline.; Scarpa Aldo author non-byline.; Zamboni Giuseppe author non-byline.; Lennon Anne Marie author non-byline.; Sund Malin author non-byline.; Kartalis Nikolaos author non-byline.; Grenacher Lars author non-byline.; Falconi Massimo author non-byline.; Arnelo Urban author non-byline.; Kopchak Kostantin V author non-byline.; Oppong Kofi author non-byline.; Mckay Colin author non-byline.; Hauge Truls author non-byline.; Conlon Kevin author non-byline.; Adham Mustapha author non-byline.; Ceyhan Güralp O author non-byline.; Salvia Roberto author non-byline.; Dervenis Christos author non-byline.; Allen Peter author non-byline.; Paye François author non-byline.; Bartsch Detlef K author non-byline.; Löhr Matthias author non-byline.; Mutignani Massimiliano author non-byline.; Laukkarinen Johanna author non-byline.; Schulick Richard author non-byline.; Valente Roberto author non-byline.; Seufferlein Thomas author non-byline.; Capurso Gabriele author non-byline.; Siriwardena Ajith author non-byline.; Neoptolemos John P author non-byline.; Pukitis Aldis author non-byline.; Segersvärd Ralf author non-byline.; Aghdassi A author non-byline.; Andrianello S author non-byline.; Bossuyt P author non-byline.; Bülow R author non-byline.; Cárdenas-Jaén K author non-byline.; Cortegoso P author non-byline.; Fontana M author non-byline.; Haeberle L author non-byline.; Heckler M author non-byline.; Litvin A author non-byline.; Mann K author non-byline.; Michalski C author non-byline.; Michl P author non-byline.; Nappo G author non-byline.; Perri G author non-byline.; Persson S author non-byline.; Scheufele F author non-byline.; Sclafani F author non-byline.; Schmidt M author non-byline.; Venezia L author non-byline.; Volker F author non-byline.; Vullierm M-P author non-byline.; Wüsten L author non-byline.;
• Is Part Of: Gut. Volume 67:Issue 5(2018)
• Page Start: 789
• Page End: 804
• Publication Date: 2018-03-24
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2018-316027
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring <40 mm without an enhancing nodule. Relative indications for surgery in IPMN include a main pancreatic duct (MPD) diameter between 5 and 9.9 mm or a cyst diameter ≥40 mm. Absolute indications for surgery in IPMN, due to the high-risk of malignant transformation, include jaundice, an enhancing mural nodule >5 mm, and MPD diameter >10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.