An advanced clinical practitioner led pancreatic cyst surveillance service

Pancreatic cysts are a common incidental finding on cross-sectional imaging. Certain cysts, such as the intraductal papillary mucinous neoplasms, carry malignant potential and require close monitoring. The purpose of surveillance is to detect lesions at an early stage when resection would be indicated. The surveillance of these pancreatic cysts is often complex and variable. This is largely because of their incidental diagnosis and the fact that they are seldom symptomatic. The author's trust recognised a need to centralise and standardise pancreatic cyst management, in line with the current international surveillance guidelines. This served as an ideal opportunity for the advanced practitioners in gastroenterology to lead the service redesign.