Portuguese Pancreatic Club Perspective on surgical approach, post-resection follow-up and role of endoscopic ablation on Pancreatic Cystic Neoplasms

Background: Pancreatic cystic neoplasms (PCNs) are lesions with malignant potential that should be addressed differently according to clinical/morphological criteria, to ensure appropriate cancer prevention while avoiding overtreatment. Summary: Surgical resection remains the gold standard for high-risk PCNs, whereas for low-risk lesions, surveillance is recommended to mitigate the non-negligible risk of postoperative complications. Endoscopic ultrasound (EUS) guided therapies, such as injection or radiofrequency, may offer a minimally invasive and effective therapeutic option particularly for patients unfit for surgery, although their impact on survival remains uncertain. Key Messages:This review summarizes the latest recommendations on surgical management and post-resection follow-up of PCNs and the potential role of EUS ablation in the treatment algorithm.