Korean J Hepatobiliary Pancreat Surg.  2013 Aug;17(3):118-125. 10.14701/kjhbps.2013.17.3.118.

Surgical management and results for cystic neoplasms of pancreas

• Han KW
• Ha R
• Kim KK
• Lee JN
• Kim YS
• Koo YS
• Park YH

• KMID: 1472527
• DOI: http://doi.org/10.14701/kjhbps.2013.17.3.118

Abstract

BACKGROUNDS/AIMS
The diagnosis for cystic neoplasm of pancreas is based on the morphologic criteria through imaging studies, but the pre- and postoperative diagnoses are often inconsistent. This study aims at the analysis of clinical characteristics and the results of surgical treatments.
METHODS
A retrospective review was performed on 93 patients who have undergone surgery for pancreatic cystic diseases in our hospital from January 2001 to February 2013. Among them, 69 patients were confirmed as cystic neoplasms based on pathologic findings. Their clinical manifestations, diagnostic accuracy, surgical method and complications, pathologic findings were analyzed.
RESULTS
Serous cystic neoplasm was the most common (n=22), followed by mucinous cystic neoplasm (n=18), intraductal papillary mucinous tumor (n=11), solid pseudopapillary tumor (n=9), neuroendocrine tumor (n=7), and cystic lymphangioma (n=2). The most common clinical symptom is abdominal pains (49.3%). Preoperative imaging studies were consistent with pathological findings in 72% of patients. Cystic fluid CEA levels of 400 ng/ml or more were reliable to detect mucin secreting tumors. Pancreatoduodenectomy was performed for 13 cases and the remaining 54 patients were treated with left-side pancreatectomy. Malignancy was found in 9 cases (13%) of mucin secreting tumors; 5 cases (27.8%) in mucinous cystic neoplasm and 4 cases (36.4%) in intraductal papillary mucinous tumor. Two of these survived without recurrences during the follow-up periods.
CONCLUSIONS
Exact treatment protocols for cystic neoplasm of pancreas are not decided because tumors are found with atypical forms. Surgical management is suggested for resectable tumors because a good prognosis can be expected with proper surgery if precancerous lesions are suspected at the time of discovery.

Keyword

Cystic neoplasm of pancreas; Malignancy; Surgical management

MeSH Terms

Abdominal Pain
Clinical Protocols
Follow-Up Studies
Humans
Lymphangioma, Cystic
Mucins
Neoplasms, Cystic, Mucinous, and Serous
Neuroendocrine Tumors
Pancreas
Pancreatectomy
Pancreatic Cyst
Pancreaticoduodenectomy
Prognosis
Recurrence
Retrospective Studies
Mucins

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