Utility of EUS-guided Microbiopsies in Pancreatic Cystic Lesions

Inclusion Criteria: * Patients 18 years old or above * Able to provide informed consent * Pancreatic cyst with a diameter of 15 mm or above OR pancreatic cyst of any size with any one of either high-risk stigmata or worrisome features (obstructive jaundice in patients with a cyst in the head of the pancreas, solid component/mural nodule, thickened/enhancing cyst wall, main pancreatic duct ≥ 10 mm or abrupt change of main pancreatic duct diameter with distal atrophy) Exclusion Criteria: * Lactating and pregnant females * Cystic lesions with a predominantly solid component, suspected of malignancy * Patients with uncorrected coagulopathy (international normalized ratio \> 1.5 or platelet count \< 50 109/L) * Patients with previous history of pancreatic cancer * Patients with a history of major stomach surgery (e.g. Billroth 1 and 2, gastrectomy, gastric bypass, esophagectomy, resection of the liver or pancreas) * Patients with disseminated malignant disease * Patients unfit for surgery * Patients where EUS-guided puncture of the lesion is not presumed technically feasible and/or safe * Patients with systemic immunosuppressive disease or receiving systemic immunosuppressive treatment * Patients with a history of recent pancreatitis (within 3 months)