This retrospective study evaluated the impact of PancraGEN on management decisions for patients with pancreatic cysts. Cases were presented to two pancreaticobiliary surgeons first without and then later with PancraGEN results, after a re-blinding period between the two instances. The two surgeons were asked to record their management recommendations in both instances. After viewing PancraGEN results, the two surgeons changed their recommended management of patients in 28% and 26% of cases, respectively. Management recommendations were changed more frequently (40% of cases) in patients who had intermediate cyst fluid CEA (45-800 ng/mL) levels and for those without an available CEA result, which can occur when cyst fluid volume is too low for CEA testing.