The treatment for a pancreatic cyst often involves no treatment at all. Small, benign cysts and pseudocysts often resolve on their own, so watchful waiting is often sufficient, though further treatment may need to be considered if they are causing any discomfort or other symptoms. If they do not clear up without treatment, a doctor should monitor them to see if they continue to grow or show any signs of turning cancerous, in which case a biopsy may be needed. Large cysts, or ones that grow larger over time and which cause issues for the patient, may need to be drained with a needle. They may also require surgical removal, particularly if there are signs that they might turn to cancer.
For many patients, a pancreatic cyst — which may not be a true cyst but a pseudocyst that lacks the specialized cells that secrete fluid into the space they occupy — will go away without treatment. Many doctors prefer to use a method called watchful waiting, where no treatment is given and the cyst is monitored for changes. Often, a benign cyst will resolve within six weeks and no intervention is required.
A pancreatic cyst that persists after a normal period of watchful waiting may still not require treatment, but typically requires monitoring. Cysts in the pancreas can grow over time, and once they get bigger than 2 centimeters they can cause back or abdominal pain, jaundice, or even become infected. They may also turn pre-cancerous or cancerous. Ongoing cysts should be checked regularly by a doctor to ensure they are not causing a problem.
Draining is sometimes the treatment for a large, symptomatic pancreatic cyst, particularly in older patients who may not be physically healthy enough for surgery. This is typically done by running an endoscope, which is a flexible tube that can be equipped with a needle for draining, into the mouth and down to the abdomen. There, the needle will be inserted into the cyst to draw out the fluid inside.
Surgery is often a good option for treating a pancreatic cyst. Young, healthy patients may prefer this option to draining, as it is often the most effective approach. It is also usually the preferred method if a biopsy indicates the cyst may become cancerous. When a pancreatic cyst is surgically removed, the chances of it returning are quite low.