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World Gastroenterology Organisation
World Gastroenterology Organisation

WGO Announces the Release of the new Pancreatic Cystic Lesions Guideline

World Gastroenterology Organisation Announces the Release of the new Pancreatic Cystic Lesions Guideline

Milwaukee, USA — April 29, 2019

The World Gastroenterology Organisation (WGO) has announced the release of the new Pancreatic Cystic Lesions Guideline.  This Guideline is chaired by Prof. Juan Malagelada of the University Hospital Vall D'Hebron in Barcelona, Spain and Dr. Nalini Guda of GI Associates in Milwaukee, Wisconsin, USA.

Prof. Malagelada stated that, "This guideline aims at providing physicians worldwide with a reasonable, up-to-date approach in the management of pancreatic cystic lesions. Since pertinent diagnostic and therapeutic resources are not uniformly available in different areas of the world, these guidelines are meant to be used as appropriate keeping in mind the local resources and patient preferences."

“Pancreatic cystic lesions” is a conventional term that refers to a well-defined lesion of the pancreas that contains fluid. Most small lesions are detected incidentally when scanning is performed for evaluation of a non-pancreas related indication or symptoms. The etiology of pancreatic cysts is variable; they may be inflammatory, post-traumatic, or have no known etiology. While most small lesions are benign, some lesions can lead to malignancy and hence the need for further workup, surveillance and management decisions. It is, thus, necessary to obtain a good history and assess the nature of the lesion by appropriate investigations as needed to assess the risk for malignant progression. Since potentially malignant lesions cannot be distinguished reliably from benign lesions on clinical and morphological features alone, further evaluation and/or surveillance may be necessary.

Dr. Guda noted that the key points and main practice statements of the Guideline are as follows:

• Careful patient history and physical evaluation are necessary;

• At initial cyst fluid aspiration: perform CEA, amylase & cytology;

• Cysts should be assessed to determine the risk for malignancy or complications;

• Molecular testing is not routinely done because of limited data and the expense, but it does
                    hold promise for the future;

• A thorough discussion with the patient regarding the diagnosis, current dilemmas in diagnosis
                    and treatment, economic and emotional burden of investigations should be had prior to
                    initiation of any surveillance strategy.


The Guideline was created with the global view of many Guideline Review Team members, which in addition to Prof. Malagelada and Dr. Guda, include: Khean-Lee Goh (Malaysia), Thilo Hackert (Germany), Peter Layer (Germany), Xavier Molero (Spain), Stephen Pandol (USA), Masao Tanaka (Japan), Muhammed Umar (Pakistan) and Anton LeMair (Netherlands).  The guideline and can be accessed at

With this new Guideline WGO now has a library of 26 Global Guidelines, which are written from a viewpoint of global applicability. Each Guideline goes through a rigorous process of authoring, editing, and peer review, and is as evidence based as possible. WGO is the only organization whose guidelines have adopted a global focus. Each WGO guideline is available in English, French, Mandarin, Portuguese, Russian and Spanish and is updated as new information and evidence is discovered. The Global Guidelines Committee meets each year to discuss updating and creating new guidelines and consists of 30-plus members from around the globe.



Formed in 1935 and incorporated in 1958, The World Gastroenterology Organisation (WGO) is a federation of 113 member societies and 4 regional associations of gastroenterology representing more than 50,000 individual members worldwide, focusing on the improvement of standards in gastroenterology training and education on a global scale. The WGO Foundation, incorporated in 2007, is dedicated to raising funds to support WGO educational programs and activities. For more information, contact:


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