Περίληψη:
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.
Συγγραφείς:
Del Chiaro, Marco
Besselink, Marc G.
Scholten, Lianne
Bruno,
Marco J.
Cahen, Djuna L.
Gress, Thomas M.
van Hooft, Jeanin
E.
Lerch, Markus M.
Mayerle, Julia
Hackert, Thilo
Satoi,
Sohei
Zerbi, Alessandro
Cunningham, David
De Angelis,
Claudio
Giovanni, Marc
de-Madaria, Enrique
Hegyi, Peter and
Rosendahl, Jonas
Friess, Helmut
Manfredi, Riccardo
Levy,
Philippe
Real, Francisco X.
Sauvanet, Alain
Abu Hilal,
Mohammed
Marchegiani, Giovanni
Esposito, Irene
Ghaneh, Paula
and Engelbrecht, Marc R. W.
Fockens, Paul
van Huijgevoort,
Nadine C. M.
Wolfgang, Christopher
Bassi, Claudio and
Gubergrits, Natalya B.
Verbeke, Caroline
Kloppel, Gunter and
Scarpa, Aldo
Zamboni, Giuseppe
Lennon, Anne Marie
Sund,
Malin
Kartalis, Nikolaos
Grenacher, Lars
Falconi, Massimo
and Arnelo, Urban
Kopchak, Kostantin V.
Oppong, Kofi
McKay,
Colin
Hauge, Truls
Conlon, Kevin
Adham, Mustapha
Ceyhan,
Guralp O.
Salvia, Roberto
Dervenis, Christos
Allen, Peter
and Paye, Francois
Bartsch, Detlef K.
Lohr, Matthias and
Mutignani, Massimiliano
Laukkarinen, Johanna
Schulick, Richard
and Valente, Roberto
Seufferlein, Thomas
Capurso, Gabriele and
Siriwardena, Ajith
Neoptolemos, John P.
Pukitis, Aldis and
Segersvard, Ralf
Aghdassi, A.
Andrianello, S.
Bossuyt, P.
and Bulow, R.
Cardenas-Jaen, K.
Cortegoso, P.
Fontana, M.
and Haeberle, L.
Heckler, M.
Litvin, A.
Mann, K. and
Michalski, C.
Michl, P.
Nappo, G.
Perri, G.
Persson, S.
and Scheufele, F.
Sclafani, F.
Schmidt, M.
Venezia, L. and
Volker, F.
Vullierm, M-P
Wusten, L.
European Study Grp
Cystic Tum
