Endoscopic management of pancreatic cystic neoplasms

Core Tip

Core Tip: Pancreatic cystic neoplasms (PCNs) represent a broad spectrum of lesions with variable malignant potential, necessitating precise risk stratification and tailored therapeutic strategies. This review synthesizes current advancements in endoscopic management, emphasizing innovations in imaging-guided risk assessment, minimally invasive interventions, and persistent challenges in clinical decision-making. The continuous development in endoscopic techniques, including endoscopic retrograde cholangiopancreatography and endoscopic ultrasound, have enabled minimally invasive alternatives to traditional surgeries for certain PCNs. However, unresolved issues persist, including optimal surveillance intervals for diverse PCN subtypes, standardization of endoscopic ablation protocols, and long-term oncologic outcomes. Additionally, resource availability and operator expertise disparities limit the global adoption of advanced endoscopic modalities. This article underscores the need for multidisciplinary collaboration, artificial intelligence-enhanced surveillance protocols, and cost-effectiveness analyses to optimize patient-centric care. The global community can harmonize management and ensure evidence-based, individualized care for this heterogeneous patient population by integrating evolving technologies with evidence-based guidelines.