When should I consider referring a patient with a pancreatic cyst to a specialist for further evaluation?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Consider referring a patient with a pancreatic cyst to a specialist for further evaluation if any of the following high-risk features are present:

  • Obstructive jaundice with cystic lesions in the head of the pancreas.
  • Enhancing solid component within the cyst.
  • Main pancreatic duct diameter of 10 mm or larger.

Additionally, offer a pancreatic protocol CT scan or MRI/MRCP initially, and if further information is needed, consider the other imaging modality or endoscopic ultrasound (EUS) with EUS-guided tissue sampling.

Referral is also indicated if malignancy is suspected based on imaging or cytology results.

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