A Review of Endoscopic Ultrasound-Guided Chemoablative Techniques for Pancreatic Cystic Lesions

Koehler, Bryn; Ryoo, Da Yeon; Krishna, Somashekar G.

doi:10.3390/diagnostics13030344

Cited by 4 publications

(1 citation statement)

References 55 publications

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“…The patient can either be monitored at different time intervals according to the adopted guideline [9], which carries the risk of missing early cancer and the burden of frequent follow-up tests, or they can be referred for surgery, which poses the risk of the patient undergoing an unnecessary major surgical intervention for what might be a benign lesion due to an inconclusive or false-positive preoperative assessment. Also, in patients unfit for surgery, there are recommendations for stopping the surveillance of PCLs [2,5,6,10]; however, this is subject to change given the development of minimally invasive therapies such as endoscopic ultrasound (EUS)-guided ablation techniques, which show promising results in published series [11,12].…”

Section: Introductionmentioning

confidence: 99%

Novel Insights into Postoperative Surveillance in Resected Pancreatic Cystic Neoplasms—A Review

Balaban,

Coman,

Balaban

et al. 2024

Diagnostics

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Pancreatic cystic lesions (PCL) are frequently encountered in clinical practice and some are referred to surgery due to their neoplastic risk or malignant transformation. The management of PCL involves complex decision-making, with postoperative surveillance being a key component for long-term outcomes, due to the potential for recurrence and postoperative morbidity. Unfortunately, the follow-up of resected patients is far from being optimal and there is a lack of consensus on recommendations with regard to timing and methods of surveillance. Here, we summarize the current knowledge on the postoperative surveillance of neoplastic pancreatic cysts, focusing on the mechanisms and risk factors for recurrence, the recurrence rates according to the initial indication for surgery, the final result of the surgical specimen and neoplastic risk in the remaining pancreas, as well as the postsurgical morbidity comprising pancreatic exocrine insufficiency, metabolic dysfunction and diabetes after resection, according to the type of surgery performed. We analyze postsurgical recurrence rates and morbidity profiles, as influenced by different surgical techniques, to better delineate at-risk patients, and highlight the need for tailored surveillance strategies adapted to preoperative and operative factors with an impact on outcomes.

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