New horizons in the endoscopic ultrasonography-based diagnosis of pancreatic cystic lesions

作     者：María-Victoria Alvarez-Sánchez Bertrand Napoléon 

作者机构：Instituto de Investigación Sanitaria Galicia Sur Complejo Hospitalario Universitario de Pontevedra Department of Gastroenterology Ramsay Générale de Santé Private Hospital Jean Mermoz 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2018年第24卷第26期

页      面：2853-2866页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Boston Scientific SA Mauna Kea Technology 

主　　题：Intraductal papillary mucinous neoplasm Pancreatic cystic lesions Endoscopic ultrasonography Confocal endomicroscopy Mucinous cystadenoma Through-the-needle cystoscopy Serous cystadenoma Through-the-needle forceps biopsy Contrast harmonic endoscopic ultrasonography 

摘      要：Pancreatic cystic lesions(PCLs) are increasingly being identified because of the widespread use of highresolution abdominal imaging. These cysts encompass a spectrum from malignant disease to benign lesions, and therefore, accurate diagnosis is crucial to determine the best management strategy, either surgical resection or surveillance. However, the current standard of diagnosis is not accurate enough due to limitations of imaging and tissue sampling techniques, which entail the risk of unnecessary burdensome surgery for benign lesions or missed opportunities of prophylactic surgery for potentially malignant PCLs. In the last decade, endoscopic innovations based on endoscopic ultrasonography(EUS) imaging have emerged, aiming to overcome the present limitations. These new EUS-based technologies are contrast harmonic EUS, needle-based confocal endomicroscopy, through-the-needle cystoscopy and through-the needle intracystic biopsy. Here, we present a comprehensive and critical review of these emerging endoscopic tools for the diagnosis of PCLs, with a special emphasis on feasibility, safety and diagnostic performance.