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WORLD GASTROENTEROLOGY NEWS JULY 2019
Editorial | Expert Point of View | WCOG 2019 | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events
“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 notes 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 can be accessed at
http://www.worldgastroenterology.
org/guidelines/global-guidelines/pancreas_
cystic_lesions.
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 at least
once each year to discuss updating and
creating new guidelines and consists
of 30-plus members from around the
globe representing various resource,
cultural, and clinical situations.
New Guidelines Translations
Available!
The new Diet and the Gut Guideline
is now available in Mandarin,
Portuguese, Russian and Spanish
translations. They can be found on
the WGO website at http://www.
worldgastroenterology.org/guidelines/
global-guidelines/diet-and-the-gut.
The updated Management of
Strongyloidiasis Guideline is now also
published in French.
WGO Guidelines and Cascades
at the World Congress of
Gastroenterology (WCOG)
Many of WGO’s Guidelines will
be highlighted as part of the robust
Scientific Program of the WCOG in
Istanbul. Be sure to attend the sessions
featuring: Celiac Disease, Diet
and the Gut, GERD, HCC, Hepatitis
B, Hepatitis C, IBD, IBS, NASH and
NAFL, and Management of Strongyloidiasis.