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Pancreatic cystic lesions are increasingly found due to the extended use of radiographic imaging techniques. These lesions have a highly variable biological behavior, ranging from completely benign and non-evolutionary to invasive with metastatic potential. There is currently no single examination allowing to obtain a precise diagnosis in all cases. Instead, all available data is considered, piecing together a puzzle and coming as close as possible to the correct final diagnosis. Cystic fluid analysis offers numerous possibilities to diagnose the type of lesion and evaluate its invasive potential.

Nowadays bariatric surgery is the most valid and safe method to treat severe cases of obesity that are refractory to the conventional restrictive dietary approaches. However, along with the increasing number of procedures performed, the incidence of post-bariatric surgery complications is also rising. The clinical and radiological work-up is difficult and variable, and treatment is both laparoscopic and endoscopic, with better efficacy and faster recovery with endoscopy. Unfortunately, there is still no clear evidence or guidelines that can help the physicians and surgeons to solve and manage the high rates of morbidity and mortality. In this chapter, the authors illustrate the most commonly adopted endoscopic and radiologic approaches and propose a therapeutic algorithm for post-bariatric surgical complications.