Citations 2
International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG
Marchegiani, Giovanni, Hegyi, Peter, Archibugi, Livia, Valente, Roberto, Capurso, Gabriele, Witt, Heiko, Bonovas, Stefanos , Maisonneuve, Patrick, Verbeke, Caroline S., Dominguez‐Muñoz, J. Enrique, Scheers, Isabelle, Czakó, László, Wagner, R, Rebours, Vinciane, Öhlund, Daniel, Gubergrits, N. B. , Engjom, Trond , Neeße, Albrecht , Apte, Minoti V. , Braren, Rickmer, Bunduc, Stefania, Ceyhan, Güralp Onur, Chouhan, Manil Dinesh, Couvelard, Anne, Iglesia, Daniel de la, Drewes, Asbjørn Mohr, Sarasqueta, A. Farina, Francque, Sven, Frøkjær, Jens Brøndum, Iglesias‐Garcia, Julio, Garg, Pramod, Gerst, Felicia, Gulbinas, Antanas, Gürcinar, Ibrahim Halil, Heni, Martin , Jonas, E G, Kitano, M., Krag, Aleksander, Laukkarinen, J., Lipp, Mónika, Loveček, M., Martignoni, Marc E., Masip, Etna , Matsumoto, Ryotaro , Mozhynа, T. L. , Nosáková, Lenka, Ockenga, Johann , Pandanaboyana, Sanjay, Panić, Nikola , Papachristou, Georgios, Pasqua, Analía V. , Pawlak, Katarzyna Monika, Regel, Ivonne , Regnér, Sara, Singh, Vijay Kumar , Smits, M., Sung, Min Je , Tacelli, Matteo, Teutsch, Brigitta, Udrescu, Mihaela, Wilschanski, Michael , Yavas, Aslihan, Zamboni, G., Löhr, J. Matthias, Singh, Vijay , Drewes, Asbjørn Mohr , Regnér, Sara , Krag, Aleksander , Marchegiani, Giovanni , Pawlak, Katarzyna M. , Marchegiani, Giovanni , Hegyi, Peter , Archibugi, Livia , Bonovas, Stefanos , Verbeke, Caroline S , de-Madaria, Enrique , Wagner, Robert , Rebours, Vinciane , Öhlund, Daniel , Neesse, Albrecht , Bezmarević, Mihailo , Bunduc, Stefania , Iglesia, Daniel de la , Drenth, Joost P H , Gürcinar, Ibrahim Halil , Jonas, Eduard , Kitano, Masayuki , Obmann, Verena , Pandanaboyana, Sanjay , Pasqua, Analia Verónica , Pawlak, Katarzyna M , Regnér, Sara , Seicean, Andrada , Sung, Min Je , Taylor, Roy , Singh, Vijay P , Krag, Aleksander , Vujasinović, Miroslav , Demir, İhsan Ekin , Hegyi, Péter , Valente, Roberto, Capurso, Gabriele , Piovani, Daniele , Rosendahl, Jonas , Maisonneuve, Patrick , Karçaaltıncaba, Muşturay , Domínguez‐Muñoz, J. Enrique , Scheers, Isabelle , Czakó, László , Idılman, Ilkay S. , Overbeek, Kasper A. , Braren, Rickmer , Chouhan, Manil Dinesh , Couvelard, Anne , Cros, Jerome F. , de‐Madaria, Enrique , Drenth, Joost P.H. , Fracasso, Pierluigi , Francque, Sven , Frøkjær, Jens Brøndum , Iglesias‐García, Julio , Garg, Pramod, Gulbinas, Antanas , Hyun, Jong Jin , Jonas, Eduard , Kiriukova, Mariia A. , Laukkarinen, Johanna , Loveček, Martin , Molven, Anders , Nosáková, Lenka , Obmann, Verena Carola , Papachristou, Georgios I. , Peláez‐Luna, Mario , Robinson, Stuart Michael , Smits, Mark M. , Tacelli, Matteo , Teutsch, Brigitta , Udrescu, Mihaela, Yavas, Aslihan , Zamboni, Giulia Angela, Löhr, J.-Matthias
United European Gastroenterology Journal | February 14, 2026 | Volume: 14 | Issue: 1 | Pages: No page available
ABSTRACT This international, multidisciplinary consensus report represents the first effort to systematically define and characterize fatty pancreas. A key outcome of this endeavor was the recommendation to adopt “fatty pancreas” as the standardized and inclusive term to describe all forms of fat accumulation in the pancreas. This terminological consensus provides a critical foundation for unified reporting and clinical communication. Another major contribution of the report is the consensus on diagnostic imaging findings, which was based on radiological and endoscopic modalities. The proposed criteria aim to enhance consistency in clinical assessment and support the development of standardized research protocols. In addition to establishing terminology and diagnostic frameworks, the report also synthesizes current knowledge across a wide range of relevant domains. These include the etiology and epidemiology of fatty pancreas, as well as its associations with alcohol consumption, smoking, acute and chronic pancreatitis, pancreatic exocrine insufficiency, type 2 diabetes mellitus, and surgical outcomes. The potential links between fatty pancreas and neoplastic conditions such as intraductal papillary mucinous neoplasms and pancreatic cancer are also addressed, alongside the current understanding of its metabolic implications (beta‐cell function and glucose homeostasis) and treatment strategies. Throughout the consensus process, a consistent theme emerged: the limited availability of high‐quality, prospective clinical data. Therefore, many of the recommendations in this report are based on expert consensus rather than strong empirical evidence. As such, the statements require rigorous prospective validation before they can be adopted into routine clinical practice. This underscores a critical need for further research, particularly studies aimed at clarifying causal relationships, validating diagnostic tools, and determining the clinical relevance of fatty pancreas across diverse patient populations. This report serves as both a summary of our current understanding and a roadmap for future investigations, aiming to close existing knowledge gaps and guide evidence‐based clinical practice in this emerging field.
The additive value of CA19.9 monitoring in a pancreatic cyst surveillance program
Levink, Iris J. M. , Jaarsma, Sanne, Koopmann, Brechtje D.M. , Riet, Priscilla A. van , Overbeek, Kasper A. , Meziani, Jihane , Sprij, Marloes L. J. A. , Polkowski, Marcin , Engels, Megan , Waaij, Laurens A. van der, Carrara, Silvia , Pando, Elizabeth , Vornhülz, Marlies , Honkoop, Pieter, Schoon, Erik J. , Laukkarinen, Johanna , Bergmann, Jilling F., Rossi, Gemma , Vilsteren, Frederike G.I. van , Berkel, Anne‐Marie van, Tabone, Trevor , Schwartz, Matthijs P. , Tan, Adriaan C.I.T.L. , Soest, Ellert van, Czacko, Laszlo, Bruno, Marco J. , Cahen, Djuna L. , group, the PACYFIC‐registry work, Engels, Megan M L, Quispel, Rutger , Casadei, Riccardo , Ingaldi, Carlo , Bergmann, Jilling F., Hooft, Jeanin E. van , group, the PACYFIC‐registry work
United European Gastroenterology Journal | July 12, 2023 | Volume: 11 | Issue: 7 | Pages: 601-611
AbstractBackgroundSurveillance of pancreatic cysts focuses on the detection of (mostly morphologic) features warranting surgery. European guidelines consider elevated CA19.9 as a relative indication for surgery. We aimed to evaluate the role of CA19.9 monitoring for early detection and management in a cyst surveillance population.MethodsThe PACYFIC‐registry is a prospective collaboration that investigates the yield of pancreatic cyst surveillance performed at the discretion of the treating physician. We included participants for whom at least one serum CA19.9 value was determined by a minimum follow‐up of 12 months.ResultsOf 1865 PACYFIC participants, 685 met the inclusion criteria for this study (mean age 67 years, SD 10; 61% female). During a median follow‐up of 25 months (IQR 24, 1966 visits), 29 participants developed high‐grade dysplasia (HGD) or pancreatic cancer. At baseline, CA19.9 ranged from 1 to 591 kU/L (median 10 kU/L [IQR 14]), and was elevated (≥37 kU/L) in 64 participants (9%). During 191 of 1966 visits (10%), an elevated CA19.9 was detected, and these visits more often led to an intensified follow‐up (42%) than those without an elevated CA19.9 (27%; p < 0.001). An elevated CA19.9 was the sole reason for surgery in five participants with benign disease (10%). The baseline CA19.9 value was (as continuous or dichotomous variable at the 37 kU/L threshold) not independently associated with HGD or pancreatic cancer development, whilst a CA19.9 of ≥ 133 kU/L was (HR 3.8, 95% CI 1.1–13, p = 0.03).ConclusionsIn this pancreatic cyst surveillance cohort, CA19.9 monitoring caused substantial harm by shortening surveillance intervals (and performance of unnecessary surgery). The current CA19.9 cutoff was not predictive of HGD and pancreatic cancer, whereas a higher cutoff may decrease false‐positive values. The role of CA19.9 monitoring should be critically appraised prior to implementation in surveillance programs and guidelines.