NICE guidance - pancreatic cysts (pancreas cyst)

Last edited 04/2018

People with pancreatic cysts

  • a pancreatic protocol CT scan or magnetic resonance cholangiopancreatography (MRI/MRCP) should be offered to people with pancreatic cysts. If more information is needed after one of these tests, offer the other one

  • refer people with any of these high-risk features for resection:
    • obstructive jaundice with cystic lesions in the head of the pancreas
    • enhancing solid component in the cyst
    • a main pancreatic duct that is 10 mm diameter or larger

  • EUS after CT and MRI/MRCP should be offered if more information on the likelihood of malignancy is needed, or if it is not clear whether surgery is needed

  • consider fine-needle aspiration during EUS if more information on the likelihood of malignancy is needed

  • when using fine-needle aspiration, perform carcinoembryonic antigen (CEA) assay in addition to cytology if there is sufficient sample.

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