Conflicting clinical guidelines make it difficult for gastroenterologists to confidently determine the best course of action when dealing with pancreatic cysts, according to Vanessa M. Shami, MD, assistant professor of medicine and director of endoscopic ultrasound at the University of Virginia Health System, Charlottesville.

“As we do more and more cross-sectional imaging, many gastroenterologists encounter more and more pancreatic cysts. But we often don’t know how to best manage them,” Dr. Shami said. “They present a diagnostic dilemma and many gastroenterologists refer them to someone else.”

Dr. Shami will co-moderate a DDW^® Clinical Symposium Sunday morning titled Pancreatic Cysts in 2017: Where are We and What is the Future? The 90-minute symposium is jointly sponsored by AGA, ASGE and SSAT.

“Our goal in this symposium is to help gastroenterologists distinguish different cyst types and give them more confidence in determining which patients they can manage, and which patients can best benefit from a referral to other gastroenterologists who specialize in this area,” said Dr. Shami, who will open the symposium with a presentation on the role of endoscopic ultrasound in managing pancreatic cysts and when it should be performed.

“As gastroenterologists, our most important tool for diagnosing these cysts is endoscopic ultrasound,” she said. “I hope to give attendees a flavor for which cysts should be sent to ultrasonographers and what tools we have to aide in their diagnosis.”

In the symposium’s second lecture, Rahul Pannala, MD, assistant professor of medicine at the Mayo Clinic Hospital, Phoenix, will address the confusion surrounding the current guidelines. Her lecture is titled “International, European, Radiology, AGA, ASGE, ACG Guidelines: How Should You Decide Which to Follow?”

“All these guidelines do make it very confusing,” Dr. Shami said. “Not only are they different, but they do conflict a bit. Dr. Pannala has the difficult task of helping the audience decide which of these guidelines to follow.”

Carlos Fernandez-del Castillo, MD, clinical co-director of the GI Cancer Center and director of the pancreas and biliary surgery program at Massachusetts General Hospital, Boston, will discuss which patients with pancreatic cysts need surgery.

“Dr. Castillo is an experienced pancreaticobiliary surgeon. Drawing on that experience, he’ll discuss how clinicians can determine who needs surgery,” Dr. Shami said. “His insight will help gastroenterologists to identify high-risk features that might indicate someone needs surgery and how it would be approached. There are some red flags that indicate a cyst is more likely to become malignant, so that is helpful knowledge to have.”

In the final lecture, Russell P. Harris, MD, MPH, professor of medicine and adjunct professor of epidemiology at the University of North Carolina, Chapel Hill, will summarize some of the key points and best practices addressed by the session’s speakers.

Please refer to the DDW Mobile App or the Program section in Sunday’s DDW Daily News for additional details on this and other DDW events.