Clinical Challenges in Hepatobiliary Surgery: Pancreatic Cysts

Behind The Knife: The Surgery Podcast

Education, Science, Health & Fitness, Medicine

4.8 • 1.4K Ratings

🗓️ 23 March 2026

⏱️ 38 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Identification of pancreatic cystic lesions has become increasingly common due to improved resolution and increased utilization of cross-sectional imaging. However, there are many types of pancreatic cysts, each with varying degrees of malignant potential. In this episode from the HPB team at Behind the Knife, listen in as we discuss the clinical presentation, diagnostic work-up, and management strategies for various pancreatic cysts: Pseudocysts, Serous Cystadenomas, Mucinous Cystic Neoplasms, and IPMNs, amongst others.

Hosts
Anish J. Jain MD (@anishjayjain) is a current PGY4 General Surgery resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center.

Jon M. Harrison MD is a Hepatobiliary & Pancreatic (HPB) surgeon at the Massachusetts General Hospital in Boston, MA and a former HPB Surgery fellow at Stanford University.

Learning Objectives
· Develop an understanding of the clinical presentation, diagnostic work-up, and treatment of benign pancreatic cysts
· Develop an understanding of the clinical presentation, diagnostic work-up, and treatment of pre-malignant pancreatic cysts
· Develop an understanding of when surveillance is appropriate for management of pancreatic cysts, and the criteria involved in making that determination
· Develop an understanding of the prognostic utility of PancSeq for IPMNs

References:

Paniccia A, Polanco PM, Boone BA, et al. Prospective, Multi-Institutional, Real-Time Next-Generation Sequencing of Pancreatic Cyst Fluid Reveals Diverse Genomic Alterations That Improve the Clinical Management of Pancreatic Cysts. Gastroenterology. 2023 Jan;164(1):117-133.e7.
- PubMed Link: https://pubmed.ncbi.nlm.nih.gov/36209796/
Ohtsuka T, Fernandez-Del Castillo C, Furukawa T, et al. International evidence-based Kyoto guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas. Pancreatology. 2024 Mar;24(2):255-270.
- PubMed Link: https://pubmed.ncbi.nlm.nih.gov/38182527/
Zelga P, Hernandez-Barco YG, Qadan M, et al. Number of Worrisome Features and Risk of Malignancy in Intraductal Papillary Mucinous Neoplasm. J Am Coll Surg. 2022 Jun 1;234(6):1021-1030.
- PubMed Link: https://pubmed.ncbi.nlm.nih.gov/35703792/
Ciprani D, Weniger M, Qadan M, et al. Risk of malignancy in small pancreatic cysts decreases over time. Pancreatology. 2020 Sep;20(6):1213-1217.
- PubMed Link: https://pubmed.ncbi.nlm.nih.gov/32819844/

***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6

Sponsor Disclaimer: Visit goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content.

Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only

Transcript

Click on a timestamp to play from that location

0:00.0	Behind the Night, The Surgery Podcast, Relevant and Engaging Content to help you dominate the day. We want you want you, yes, you, to join the Behind the Knife team as a surgical education fellow.
0:39.9	We're looking for enterprising surgical residents to take the bull by the horns and build something new and exciting.
0:46.6	Fellows will benefit from ample support from the Behind the Knife team, including the use of our digital education platform,
0:52.8	and access to all of our resources like
0:54.8	illustrators, video editing, AI tools, social media, and more.
0:59.7	Get your name out there and build your CV by being part of the number one surgery education
1:04.2	platform in the world. We're offering a two-year fellowship starting July 26 and ending in June 28.
1:12.4	Only residents beginning their two-year academic development time will be considered.
1:16.9	Check out the show notes for more information, including the application link.
1:20.4	All applications are due on April 20th.
1:23.7	Again, all applications are due by April 20th.
1:27.8	Greetings, everyone. Welcome to another HB episode on Behind the Knife. This is your
1:32.6	HPV team coming to you from Stanford University in California and Massachusetts General
1:37.5	Hospital in Boston. I'm a niche, a PGY4 general surgery resident here at Stanford, and I'm
1:43.1	excited to be joined by a great friend and mentor and Dr. John Harrison,
1:46.5	a former HB fellow at Stanford and current HB faculty at MGH.
1:51.5	Today's topic is pancreatic cysts.
1:54.0	We'll discuss the different types of pancreatic cysts, how they're diagnosed, the workup of these various cysts,
2:00.0	and how it changes based on our
2:01.8	suspicions, and when surveillance versus resection is appropriate. So before we jump into all the
2:09.1	details, John, I think the best thing to start with is your classification of pancreatic cysts.
2:14.1	And you've done this a few different ways for us. So if you just break it down into,
	...

Please login to see the full transcript.

Previous episode | Next episode

Disclaimer: The podcast and artwork embedded on this page are from Behind The Knife: The Surgery Podcast, and are the property of its owner and not affiliated with or endorsed by Tapesearch.

Generated transcripts are the property of Behind The Knife: The Surgery Podcast and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.