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Pancreatic cyst management

Imaging Management of Pancreatic Cysts (benign-appearing cyst in asymptomatic patient)

1-5 mm. Too small to characterize, considered benign. No further imaging follow-up recommended.

6-9 mm. Consider single follow-up in 2-3 years, preferably MRCP/MRI pancreas. If stable at follow-up, no further imaging follow-up recommended.

1-1.9 cm. Consider follow-up MRCP/MRI or CT pancreas in 1-2 years. If stable at follow-up, lengthen interval imaging follow-up to 2-3 years.

2-2.9 cm. Consider baseline EUS, then follow-up MRCP/MRI or CT pancreas in 6-12 months. Consider surgery in young, fit patients with need for prolonged surveillance. If stable at follow-up, lengthen interval imaging follow-up to 1-2 years.

>=3 cm. Consider baseline or follow-up EUS, then follow-up MRCP/MRI or CT pancreas in 3-6 months. Strongly consider surgery in young, fit patients. For serous cystadenoma, consider referral to Surgery when >4 cm.

If growth at any follow-up interval, follow the algorithm for the next cyst size category.

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