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Pancreatic Cystic Lesions in Children: A Comprehensive Scoping Review
Jacob A Mark1, Yuhua Zheng2, Salvador Rodriguez Franco3
1From the Digestive Health Institute, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO.
Insights
Pediatric pancreatic cystic lesions (PPCLs) are rare and distinct from adult types. This review provides evidence-based guidelines for evaluating and managing these uncommon pediatric conditions.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Oncology
Background:
- Pediatric pancreatic cystic lesions (PPCLs) are uncommon and poorly understood, differing significantly from adult counterparts.
- Limited literature exists on the etiology, evaluation, and management of PPCLs.
- A multidisciplinary working group convened to address this knowledge gap.
Approach:
- A scoping review was conducted, combining a targeted literature review for PPCL description and a systematic review for management recommendations.
- The systematic review involved a two-stage screening process: title/abstract review followed by full-text assessment.
- This approach ensured a comprehensive analysis of existing evidence.
Key Points:
- 131 studies were included in the systematic review, with an additional 20 in the targeted search.
- Five neoplastic and 10 nonneoplastic PPCL types were identified, with varying prevalence in children versus adults.
- Evidence-based recommendations and management algorithms for PPCLs are presented.
Conclusions:
- This work offers a comprehensive review and evidence-based management strategies for pediatric pancreatic cystic lesions.
- It highlights areas where current literature is insufficient, emphasizing the need for further research.
- Management algorithms are provided to guide clinical decision-making for PPCLs.
Objective:
Pediatric pancreatic cystic lesions (PPCLs) are uncommon and differ from adult pancreatic cystic lesions. Literature is limited on the etiologies, evaluation, and management of PPCL. A multidisciplinary working group formed to provide a comprehensive description of PPCL and recommend best available evidence-based evaluation and management.
Materials And Methods:
The PPCL working group performed a scoping review by 2 methods: 1) a targeted literature review to describe PPCL and 2) a systematic literature review for management recommendations for PPCL. The systematic review was completed using a 2-stage sifting approach: title and abstract screening followed by a full text review.
Results:
One hundred thirty-one studies were included in the systematic review and an additional 20 were included in the targeted search to complete a comprehensive list of PPCL. Five neoplastic PPCL and 10 nonneoplastic PPCL were identified, and prevalence of different cystic lesions differs widely in adults and children. Recommendations on evaluation and management of PPCL are presented based on best available evidence.
Conclusions:
We present a comprehensive review and evidence-based management recommendations with management algorithms for pediatric pancreatic cystic lesions. Given the rarity of many of these entities, this review also highlights many aspects of PPCL, which are not adequately described in the current literature.
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