Pancreatic cystic neoplasms (PCN) are a heterogeneous group of pancreatic cysts that include intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, serous cystic neoplasms and other rare cystic lesions, all with different biological behaviours and variable risk of progression to malignancy. As more pancreatic cysts are incidentally discovered on routine cross-sectional imaging, optimal surveillance for patients with PCN is becoming an increasingly common clinical problem, highlighting the need to balance cancer prevention with the risk of (surgical) overtreatment. This Review summarizes the latest developments in the diagnosis and management of PCN, including the quality of available evidence. Also discussed are the most important differences between the PCN guidelines from the American Gastroenterological Association, the International Association of Pancreatology and the European Study Group on Cystic Tumours of the Pancreas, including diagnostic and follow-up strategies and indications for surgery. Finally, new developments in the management of patients with PCN are addressed.

胰腺囊性肿瘤（PCN）是一组异质性胰腺囊肿，包括导管内乳头状粘液性肿瘤，粘液性囊性肿瘤，浆液性囊性肿瘤和其他罕见的囊性病变，它们均具有不同的生物学行为和发展为恶性肿瘤的风险可变。随着在常规横截面成像中偶然发现更多的胰腺囊肿，对PCN患者的最佳监视已成为越来越普遍的临床问题，这凸显了在癌症预防与（手术）过度治疗的风险之间取得平衡的需要。这篇综述总结了PCN诊断和管理的最新进展，包括现有证据的质量。还讨论了美国胃肠病学协会PCN指南之间最重要的区别，国际胰腺病学协会和欧洲胰腺囊性肿瘤研究小组，包括诊断和随访策略以及手术适应症。最后，讨论了PCN患者管理方面的新发展。