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Pancreatic Cysts

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Management Î The AGA suggests against continued surveillance of pancreatic cysts if there has been no significant change in the characteristics of the cyst after 5 years of surveillance or if the patient is no longer a surgical candidate. (Conditional; Very Low Quality of Evidence) Î The AGA suggests that patients with both a solid component and a dilated pancreatic duct and/or concerning features on EUS and FNA should undergo surgery to reduce the risk of mortality from carcinoma. (Conditional; Very Low Quality of Evidence) Î The AGA recommends that if surgery is considered for a pancreatic cyst, patients are referred to a center with demonstrated expertise in pancreatic surgery. (Strong; Very Low Quality of Evidence) Î The AGA suggests that patients with invasive cancer or dysplasia in a cyst that has been surgically resected should undergo MRI surveillance of any remaining pancreas every 2 years. (Conditional; Very Low Quality of Evidence) Î The AGA suggests against routine surveillance of pancreatic cysts without high-grade dysplasia or malignancy at surgical resection. (Conditional; Very Low Quality of Evidence)

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