Korean J Intern Med.  2022 Jan;37(1):63-72. 10.3904/kjim.2020.452.

Current trends in the management of pancreatic cystic neoplasms in Korea: a national survey

• Chon HK
• Moon SH
• Park SW
• Paik WH
• Paik CN
• Son BK
• Song TJ
• Ahn DW
• Lee ES
• Lee YN
• Lee YS
• Lee JM
• Jeon TJ
• Park CH
• Cho KB
• Lee DW

• KMID: 2524242
• DOI: http://doi.org/10.3904/kjim.2020.452

Abstract

Background/Aims
The study aimed to investigate the current practice patterns in the management of pancreatic cystic neoplasms in Korea.
Methods
An electronic survey was systematically distributed by email to members of the Korean Pancreatobiliary Association from December 2019 to February 2020.
Results
In total, 115 (110 gastroenterologists, five surgeons) completed the survey, 72.2% of whom worked in a tertiary/academic medical center. Most (65.2%) followed the 2012/2017 International Association of Pancreatology guidelines for the management of pancreatic cystic neoplasms. A gadolinium-enhanced magnetic resonance imaging/magnetic resonance cholangiopancreatography was the most common first-line diagnostic modality (42.1%), but a contrast-enhanced computed tomography scan was preferred as a subsequent surveillance tool (58.3%). Seventy- four percent of respondents routinely performed endoscopic ultrasound-guided fine needle aspiration for pancreatic cystic neoplasms with suspicious mural nodules. Endoscopic ultrasound-guided fine needle aspiration cytology (94.8%) and cystic fluid carcinoembryonic antigen (95.7%) were used for cystic fluid analysis. Most (94%) typically recommended surgery in patients with high-risk stigmata, but 18.3% also considered proceeding with surgery in patients with worrisome features. Most (96.5%) would continue surveillance of pancreatic cystic neoplasms for more than 5 years.
Conclusions
According to this survey, there was variability in the management of pancreatic cystic neoplasms among the respondents. These results suggest that the development of evidence-based guidelines for pancreatic cystic neoplasms that fit the Korean practice is needed to create an optimal approach to the management of pancreatic cystic neoplasms.

Keyword

Pancreatic cyst; Survey; Korea