Role of Endoscopy in the Diagnosis and Treatment of Cystic Pancreatic Neoplasms

Publication Date: July 2, 2016
Last Updated: March 14, 2022


We recommend EUS-FNA of any pancreatic cystic lesion over 3 cm in diameter or when cross-sectional or EUS imaging confirms an epithelial nodule, dilated main pancreatic duct, or suspicious mass lesion. (⊕⊕⊕o)

We suggest that EUS-FNA is optional in asymptomatic patients in whom cross-sectional imaging demonstrates a cyst <3 cm and without either a mass and/or epithelial nodule or associated dilated main pancreatic duct. (⊕⊕oo)

We recommend initial testing of aspirated pancreatic cyst fluid for CEA, amylase, and cytology. (⊕⊕⊕o)

We suggest that molecular testing of the cyst be considered when initial ancillary testing of cytology and CEA is inconclusive and when test results may alter management. (⊕⊕oo)

We suggest administration of prophylactic antibiotics for patients undergoing EUS-FNA for the evaluation of cystic pancreatic neoplasms. (⊕⊕oo)

We suggest that ERCP, pancreatoscopy, and intraductal US may be helpful in the diagnosis and characterization of suspected main duct IPMNs. (⊕⊕oo)

Recommendation Grading



Role of Endoscopy in the Diagnosis and Treatment of Cystic Pancreatic Neoplasms

Authoring Organization

Publication Month/Year

July 2, 2016

Last Updated Month/Year

January 19, 2024

Document Type


External Publication Status


Country of Publication


Document Objectives

This guideline supplements and replaces previous document on the role of endoscopy in the diagnosis and the management of cystic lesions and inflammatory fluid collections of the pancreas.

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Hospital, Outpatient

Intended Users

Radiology technologist, nurse, nurse practitioner, physician, physician assistant


Assessment and screening, Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D000230 - Adenocarcinoma, D010181 - Pancreatic Cyst, D010190 - Pancreatic Neoplasms


endoscopy, Endoscopic ultrasound FNA, cystic pancreatic neoplasms

Source Citation

Muthusamy, V. R., Chandrasekhara, V., Acosta, R. D., Bruining, D. H., Chathadi, K. V., Eloubeidi, M. A., … DeWitt, J. M. (2016). The role of endoscopy in the diagnosis and treatment of cystic pancreatic neoplasms. Gastrointestinal Endoscopy, 84(1), 1–9. doi:10.1016/j.gie.2016.04.014


Number of Source Documents
Literature Search Start Date
January 2, 1990
Literature Search End Date
September 2, 2015