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Article: The Hong Kong consensus recommendations on the diagnosis and management of pancreatic cystic lesions
Title | The Hong Kong consensus recommendations on the diagnosis and management of pancreatic cystic lesions |
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Authors | |
Issue Date | 1-Oct-2023 |
Publisher | AME Publishing |
Citation | Hepatobiliary Surgery and Nutrition, 2023, v. 12, n. 5, p. 715-715 How to Cite? |
Abstract | Background: The finding of pancreatic cystic lesions (PCL) on incidental imaging is becoming increasingly common. International studies report a prevalence of 2.2–44.7% depending on the population, imaging modality and indication for imaging, and the prevalence increases with age. Patients with PCL are at risk of developing pancreatic cancer, a disease with a poor prognosis. This publication summarizes recommendations for the diagnosis and management of PCL and post-operative pancreatic exocrine insufficiency (PEI) from a group of local specialists. Methods: Clinical evidence was consolidated from narrative reviews and consensus statements formulated during two online meetings in March 2022. The expert panel included gastroenterologists, hepatobiliary surgeons, oncologists, radiologists, and endocrinologists. Results: Patients with PCL require careful investigation and follow-up due to the risk of malignant transformation of these lesions. They should undergo clinical investigation and pancreas-specific imaging to classify lesions and understand the risk profile of the patient. Where indicated, patients should undergo pancreatectomy to excise PCL. Following pancreatectomy, patients are at risk of PEI, leading to gastrointestinal dysfunction and malnutrition. Therefore, such patients should be monitored for symptoms of PEI, and promptly treated with pancreatic enzyme replacement therapy (PERT). Patients with poor response to PERT may require increases in dose, addition of a proton pump inhibitor, and/or further investigation, including tests for pancreatic function. Patients are also at risk of new-onset diabetes mellitus after pancreatectomy; they should be screened and treated with insulin if indicated. Conclusions: These statements are an accurate summary of our approach to the diagnosis and management of patients with PCL and will be of assistance to clinicians treating these patients in a similar clinical landscape. |
Persistent Identifier | http://hdl.handle.net/10722/339064 |
ISSN | 2022 Impact Factor: 8.0 |
DC Field | Value | Language |
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dc.contributor.author | Cheung, Tan-To | - |
dc.contributor.author | Lee, Yuk Tong | - |
dc.contributor.author | Tang, Raymond Shing-Yan | - |
dc.contributor.author | She, Wong Hoi | - |
dc.contributor.author | Cheng, Kai Chi | - |
dc.contributor.author | Cheung, Chin Cheung | - |
dc.contributor.author | Chiu, Keith Wan Hang | - |
dc.contributor.author | Chok, Kenneth Siu Ho | - |
dc.contributor.author | Chow, Wing Sun | - |
dc.contributor.author | Lai, Tak Wing | - |
dc.contributor.author | Seto, Wai-Kay | - |
dc.contributor.author | Yau, Thomas | - |
dc.date.accessioned | 2024-03-11T10:33:36Z | - |
dc.date.available | 2024-03-11T10:33:36Z | - |
dc.date.issued | 2023-10-01 | - |
dc.identifier.citation | Hepatobiliary Surgery and Nutrition, 2023, v. 12, n. 5, p. 715-715 | - |
dc.identifier.issn | 2304-3881 | - |
dc.identifier.uri | http://hdl.handle.net/10722/339064 | - |
dc.description.abstract | <p><strong>Background: </strong>The finding of pancreatic cystic lesions (PCL) on incidental imaging is becoming increasingly common. International studies report a prevalence of 2.2–44.7% depending on the population, imaging modality and indication for imaging, and the prevalence increases with age. Patients with PCL are at risk of developing pancreatic cancer, a disease with a poor prognosis. This publication summarizes recommendations for the diagnosis and management of PCL and post-operative pancreatic exocrine insufficiency (PEI) from a group of local specialists.</p><p><strong>Methods: </strong>Clinical evidence was consolidated from narrative reviews and consensus statements formulated during two online meetings in March 2022. The expert panel included gastroenterologists, hepatobiliary surgeons, oncologists, radiologists, and endocrinologists.</p><p><strong>Results: </strong>Patients with PCL require careful investigation and follow-up due to the risk of malignant transformation of these lesions. They should undergo clinical investigation and pancreas-specific imaging to classify lesions and understand the risk profile of the patient. Where indicated, patients should undergo pancreatectomy to excise PCL. Following pancreatectomy, patients are at risk of PEI, leading to gastrointestinal dysfunction and malnutrition. Therefore, such patients should be monitored for symptoms of PEI, and promptly treated with pancreatic enzyme replacement therapy (PERT). Patients with poor response to PERT may require increases in dose, addition of a proton pump inhibitor, and/or further investigation, including tests for pancreatic function. Patients are also at risk of new-onset diabetes mellitus after pancreatectomy; they should be screened and treated with insulin if indicated.</p><p><strong>Conclusions: </strong>These statements are an accurate summary of our approach to the diagnosis and management of patients with PCL and will be of assistance to clinicians treating these patients in a similar clinical landscape.</p> | - |
dc.language | eng | - |
dc.publisher | AME Publishing | - |
dc.relation.ispartof | Hepatobiliary Surgery and Nutrition | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.title | The Hong Kong consensus recommendations on the diagnosis and management of pancreatic cystic lesions | - |
dc.type | Article | - |
dc.identifier.doi | 10.21037/hbsn-22-471 | - |
dc.identifier.volume | 12 | - |
dc.identifier.issue | 5 | - |
dc.identifier.spage | 715 | - |
dc.identifier.epage | 715 | - |
dc.identifier.eissn | 2304-389X | - |
dc.identifier.issnl | 2304-3881 | - |