Prevalence of incidental pancreatic cyst on upper endoscopic ultrasound

Abstract

Background:This study aimed to determine the prevalence of incidental pancreatic cysts in patients undergoing upper endoscopic ultrasound without a known pancreatic abnormality.Methods:This prospective study was conducted in two hospitals in Spain and enrolled consecutive patients referred for upper endoscopic ultrasound for a condition unrelated to the pancreas. Patients with a previous pancreatic anomaly, history of acute or chronic pancreatitis, evidence of acute pancreatitis, previous upper gastrointestinal surgery, or chronic abdominal pain suggestive of pancreatic origin were excluded. Univariate logistic regression was performed to evaluate individual covariates and the incidental pancreatic cyst risk.Results:A total of 298 patients were included, of whom 64 had pancreatic cysts (21.5%; 16.9-26.6%). The mean size of the cysts was 6.3±3.7 (range 3-25) mm. Six cysts (2%) were >10 mm and 16 (5.4%) were compatible with branch duct intraductal papillary mucinous neoplasm. The pancreatic cyst prevalence was similar in the two hospitals and increased significantly with age.Conclusion:The prevalence of incidental pancreatic cysts during endoscopic ultrasound was very high in our study population.

Endoscopic ultrasound-guided, through-the-needle forceps biopsy for diagnosis of pancreatic cystic lesions: a systematic review

“…In the meta-analysis of Zerboni G, et al in 2019, prevalence of PCLs in asymptomatic individuals was 8 % [23], while incidence of these lesions increases with age and reaches 37 % in patients older than 80 [24]. In Spain, a prospective study performed in 298 patients, the authors recorded that incidental prevalence of pancreatic cysts on EUS (21.5 %) was higher than prevalence estimates in cross-sectional imaging studies [6]. Surgery is currently considered the standard of care for malignant and highrisk premalignant PCLs.…”

“…Magnetic resonance imaging and magnetic resonance cholangiopancreatography are superior to computed tomography in identifying communication between a PCL and the pancreatic duct, the number of PCLs, and presence of a mural nodule [5]. In Spain, a prospective study performed in 298 patients showed that prevalence of unexpected PCLs on endoscopic ultrasound (EUS) is 21.5 %, higher than the prevalence estimates in cross-sectional imaging studies [6]. Currently, the management of PCLs relies on the combination of clinical features, cross-sectional imaging and endoscopic ultrasound with or without fine-needle aspiration (FNA) and fluid analysis.…”

Pancreatic cancer screening in patients with presumed branch-duct intraductal papillary mucinous neoplasms

“…The reported prevalence rates for pancreatic cysts have varied depending on the imaging method used for detection. Namely, the reported detection rates have been for 2.2%-2.6%[17,18] for computed tomography (CT), 3.5%[19] for US, 10%-44.7%[10,16,18,20-22] for MRI, and 9.4%-21.5%[23,24] for endoscopic ultrasonography (EUS). A similar amount of reports[10,14,16,17,19-21,23,24] have demonstrated aging as a significant risk factor for pancreatic cysts; in general, the frequency of pancreatic cysts among the elderly is over 20%.…”

Pancreatic cyst: What clinician needs?

“…Looking at cross-sectional imaging studies on general population, the prevalence of pancreatic cyst widely ranges between 2.4% and 49% with a mean value estimated in about 12%[ 5 6 7 8 9 10 11 12 13 14 15 ] [ Table 1 ]. This impressive number becomes even more clinically significant, considering that only about 1% of patients have a cyst >2 cm.…”