The Role of EUS in Pancreatic Cysts

Abstract

Pancreatic cystic lesions (PCLs) comprise various pathologically different groups of lesions that usually share many common clinical features. Cystic lesions and fluid collections of the pancreas often present a diagnostic and therapeutic challenge. Pancreatic cystic lesions are being diagnosed with increasing frequency owing to the widespread use of cross-sectional imaging. The differential diagnosis for cystic lesions of the pancreas is broad, and the role of endoscopic ultrasonography (EUS) is becoming more clearly defined. EUS has become an important tool in the diagnosis and risk stratification of pancreatic cysts. The ability of EUS to provide detailed imaging, tissue, and cyst fluid for analysis makes it a seemingly powerful diagnostic tool for PCLs. It can accurately visualize the cyst morphology, assess vascular pattern by contrast harmonic scan, and perform fine-needle aspiration (FNA) for evaluation of cytology and molecular markers. Furthermore, several studies have shown the therapeutic applications of endoscopic ultrasound in management of PCLs, including EUS-guided ablation of cystic pancreatic tumors by injection of alcohol, aiding in pancreatic pseudocyst drainage.