Currently, rates of pancreatic cysts appear to be increasing due to an aging population and also increased use of cross sectional imaging such as CT scans and MRI. The overall incidence ranges anywhere between 2-38% in general population. Pancreatic cysts may or may not have the potential to turn into cancer. The overall risk of cancer in a single pancreatic cyst at initial diagnosis is quite low, but can exist in certain lesions such as mucinous cysts (IPMNs, MCNs).
Our goal as Gastroenterologists is to diagnose lesions based on our current predictive capabilities which included clinical history, radiographic imaging, endoscopic ultrasound (EUS) and cyst fluid analysis/cytology. Guidelines on diagnosis, management, surveillance of these cystic lesions are available, which we use to help guide our evaluation and intervention. Currently Endoscopic Ultrasound (EUS) is the best test to evaluate cysts as it allows for excellent imaging and also sampling (fine needle aspiration FNA) of the cyst fluid with a needle. EUS is a minimally invasive procedure to assess digestive (gastrointestinal) diseases. It uses high-frequency sound waves to produce detailed images of the lining and walls of your digestive tract and chest, nearby organs such as the pancreas and liver, and lymph nodes. EUS–FNA of pancreas cysts has been associated with very low risk of complications and is very effective in evaluating pancreatic cysts.
There is no preparation the patients must drink for the EBT. Patients only need to be NPO (or not eating/drinking) after midnight prior to the procedure. They are sedated with deep short-acting anesthesia (without a breathing tube/intubation) and then discharged the same day home (outpatient procedure). The procedure usually takes around 30 minutes to perform.