Protocolo diagnóstico de las lesiones sólidas y quísticas pancreáticas

Abstract

Solid Pancreatic Lesions (SPL) are usually symptomatic and mainly corresponding to a pancreatic cancer. CT scan and MR imaging are often performed as initial evaluation. Endoscopic Ultrasound (EUS) is the best technique for the differential diagnosis of a SPL. EUS allows the detection of small lesions, assess the resectability of the tumor and perform EUS-guided sampling for obtaining a final diagnosis in most cases. The vast majority of Cystic Pancreatic Lesions (CPL) are incidentally found. The main point is to distinguish benign from potential malignant lesions, as mucinous CPL (Intraductal Papillary Mucinous Neoplasm – IPMN and Mucinous Cystic Neoplasm). EUS and MRI with Cholangiopancreatography (MRCP) are the best techniques in the characterization. Therapeutic approach is mainly based on the presence of warning signs, being the international guidelines an important tool for the management. Age and comorbidities must be taken into account in therapeutic decision (surgical treatment vs surveillance).