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胰腺囊性肿瘤的发病率逐渐增加，临床最佳诊治策略在既往几十年中发生了持续的改进，诊断和治疗中的一些问题需要审慎思考和决策，以获得最佳的疗效，并避免过度治疗。本文分析了胰腺囊性肿瘤鉴别诊断的新进展、治疗决策和手术范围、未手术患者的长期随访等问题。总体来看，目前胰腺囊性肿瘤的诊疗决策在证据逐渐丰富的情况下更全面和科学，强调了精准诊疗、平衡治疗的风险和获益。

The incidence of pancreatic cystic neoplasms increased dramatically. The clinically optimal management guideline for pancreatic cysts has continued to improve in previous decades. Some issues in diagnosis and treatment require careful consideration and decision-making to achieve the best therapeutic effect and avoid overtreatment. This article analyzes the new progress in the differential diagnosis of pancreatic cystic tumors, surgical decision-making and scope of surgery, and long-term follow-up of patients who have not undergone surgery. In general, the current diagnosis and treatment decisions for pancreatic cystic tumors are more comprehensive and scientific as evidence becomes increasingly abundant, emphasizing the risks and benefits of precise diagnosis and treatment and balanced treatment.