A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?

Abdulwahab Meqbel; Saad Alwadai; Ghadah Alnikaiden; Renad Aljasser; Fares Alghamdi; Abdulrahman Muqbil; Ohud Alobaid; Mutaz Alamri; Abdullah Althobaiti; Bader Alotibi

doi:10.24911/IJMDC.51-1784818719

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Online Published: 20 Sep 2026

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doi: 10.24911/IJMDC.51-1784818719

A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?

Abdulwahab Meqbel, Saad Alwadai, Ghadah Alnikaiden, Renad Aljasser, Fares Alghamdi, Abdulrahman Muqbil, Ohud Alobaid, Mutaz Alamri, Abdullah Althobaiti, Bader Alotibi.

Abstract
Pancreatic cystic lesions (PCLs) are discovered in 2–15% of adults performing abdominal scanning. Various guidelines have proposed varied thresholds for surveillance, evaluation, and management, which have led to marked practice variation. The International Association of Pancreatology has established the 2024 Kyoto guidelines that categorize cystic lesions into three groups based on a risk stratification framework incorporating morphological, clinical, and molecular criteria. This framework is the most complete system currently available, but it has two gaps. First, Kyoto did not specify where to set the artificial intelligence (AI) models in the management algorithm. Second, the Kyoto guidelines lacked guidance on technique selection, pre-ablation workup, or post-ablation surveillance regarding endoscopic ablation for those not eligible for surgery. This review followed the history of the guideline from Sendai through Kyoto 2024. Early data revealed poor adherence to the management of patients with pancreatic cysts in accordance with Kyoto recommendations in routine practice. The emerging tools, such as AI, might help close this implementation gap. Nonetheless, prospective multicenter validation for ablation modalities and AI models remains necessary before implementation into clinical workflows.

Key words: PCLs, Kyoto 2024 guidelines, AI, Endoscopic ultrasound, EUS-guided ablation, narrative review

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Pubmed Style

Meqbel A, Alwadai S, Alnikaiden G, Aljasser R, Alghamdi F, Muqbil A, Alobaid O, Alamri M, Althobaiti A, Alotibi B. A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?. IJMDC. Online First: 20 Sep, 2026. doi:10.24911/IJMDC.51-1784818719

Web Style

Meqbel A, Alwadai S, Alnikaiden G, Aljasser R, Alghamdi F, Muqbil A, Alobaid O, Alamri M, Althobaiti A, Alotibi B. A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?. https://www.ijmdc.com/?mno=328772 [Access: September 21, 2026]. doi:10.24911/IJMDC.51-1784818719

AMA (American Medical Association) Style

Meqbel A, Alwadai S, Alnikaiden G, Aljasser R, Alghamdi F, Muqbil A, Alobaid O, Alamri M, Althobaiti A, Alotibi B. A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?. IJMDC. Online First: 20 Sep, 2026. doi:10.24911/IJMDC.51-1784818719

Vancouver/ICMJE Style

Meqbel A, Alwadai S, Alnikaiden G, Aljasser R, Alghamdi F, Muqbil A, Alobaid O, Alamri M, Althobaiti A, Alotibi B. A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?. IJMDC, [cited September 21, 2026]; Online First: 20 Sep, 2026. doi:10.24911/IJMDC.51-1784818719

Harvard Style

Meqbel, A., Alwadai, . S., Alnikaiden, . G., Aljasser, . R., Alghamdi, . F., Muqbil, . A., Alobaid, . O., Alamri, . M., Althobaiti, . A. & Alotibi, . B. (2026) A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?. IJMDC, Online First: 20 Sep, 2026. doi:10.24911/IJMDC.51-1784818719

Turabian Style

Meqbel, Abdulwahab, Saad Alwadai, Ghadah Alnikaiden, Renad Aljasser, Fares Alghamdi, Abdulrahman Muqbil, Ohud Alobaid, Mutaz Alamri, Abdullah Althobaiti, and Bader Alotibi. 2026. A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?. International Journal of Medicine in Developing Countries, Online First: 20 Sep, 2026. doi:10.24911/IJMDC.51-1784818719

Chicago Style

Meqbel, Abdulwahab, Saad Alwadai, Ghadah Alnikaiden, Renad Aljasser, Fares Alghamdi, Abdulrahman Muqbil, Ohud Alobaid, Mutaz Alamri, Abdullah Althobaiti, and Bader Alotibi. "A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?." International Journal of Medicine in Developing Countries Online First: 20 Sep, 2026. doi:10.24911/IJMDC.51-1784818719

MLA (The Modern Language Association) Style

Meqbel, Abdulwahab, Saad Alwadai, Ghadah Alnikaiden, Renad Aljasser, Fares Alghamdi, Abdulrahman Muqbil, Ohud Alobaid, Mutaz Alamri, Abdullah Althobaiti, and Bader Alotibi. "A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?." International Journal of Medicine in Developing Countries Online First: 20 Sep, 2026. Web. 21 Sep 2026 doi:10.24911/IJMDC.51-1784818719

APA (American Psychological Association) Style

Meqbel, A., Alwadai, . S., Alnikaiden, . G., Aljasser, . R., Alghamdi, . F., Muqbil, . A., Alobaid, . O., Alamri, . M., Althobaiti, . A. & Alotibi, . B. (2026) A narrative review of pancreatic cyst guidelines, AI-based risk assessment, and endoscopic ablation: where do we stand after Kyoto 2024?. International Journal of Medicine in Developing Countries, Online First: 20 Sep, 2026. doi:10.24911/IJMDC.51-1784818719

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