Analysis of Diagnosis and Treatment of Pancreatic Cystic Tumors_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Yajun , LI Fei , SUN Jiabang , LI Ang , CAO Feng , FANG Yu , LI Jia , JIA jianguo , CHEN Hong , YANG Peng

Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;

Corresponding author：

Keywords：

Pancreatic neoplasms; Serous cystic tumor; Mucinous cystic tumor; Intraductal papillary mucinous tumor; Solid pseudopapillary tumor

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Objective 　To discuss the methods of diagnosis and treatment of cystic neoplasms of pancreas.
Methods 　Demographic data, clinical manifestations, diagnostic exams, surgical procedures, pathological diagnosis, postoperative complications, and follow-up data of 29 patients with cystic neoplasms of pancreas were analyzed retrospectively.
Results 　There were 8 （28%） serous cystic tumors （SCN）, 12 （41%） mucinous cystic tumors （MCN）, 3 （10%） intraductal papillary mucinous tumors （IPMN）, and 6 （21%） solid pseudopapillary tumors （SPT）. Eight cases of SCN, 7 cases of MCN, 1 case of IPMN, and 5 cases of SPT were all benign. The ages of the patients were from 15 to 78 years〔average, （49±17）years〕and all tumors were more common in female （76%, 22/29）. Twenty-three cases of 29 patients were performed operations, 22 cases were underwent surgical resection, and 1 case was performed exploration and biopsy. There was no surgery-related death. The rest 6 cases were not performed operation. Twenty-one cases followed-up for 6 months to 8 years 〔average, （2.7±2.3） years〕, 8 cases didn’t followed-up. Sixteen cases with surgical resection had no recurrence during follow-up period, 1 case performed exploration and biopsy died in 1 year after operation, and 4 cases of SCN without surgery didn’t deteriorate.
Conclusions 　The most common cystic neoplasms of pancreas are mucinous and serous cysts. These tumors are more frequent in female. Although almost all serous cysts are benign, 42% of mucinous cysts are malignant. Misdiagnosis may delay appropriate treatment and increase mortality. The resection rate of pancreatic cystic tumor is high, and the prognosis is good after radical resection.

Citation： WANG Yajun,LI Fei,SUN Jiabang,LI Ang,CAO Feng,FANG Yu,LI Jia,JIA jianguo,CHEN Hong,YANG Peng,.. Analysis of Diagnosis and Treatment of Pancreatic Cystic Tumors. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(4): 424-428. doi: Copy

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14.	Bassi C， Salvia R， Molinari E， et al. Management of 100 consecutive cases of pancreatic serous cystadenoma：wait for symptoms and see at imaging or vice-versa?[J]. World J Surg， 2003，27(3)：319-323.
15.	Society for Surgery of the Alimentary Tract. SSAT patient care guidelines. Cystic neoplasms of the pancreas [J]. J Gastrointest Surg， 2007， 11(9)：1225-1227.
16.	孙备，陈华. 胰腺癌外科治疗的现状与展望 [J]. 中国普外基础与临床杂志， 2008， 15(8)：547-549.
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20.	Sugiyama M， Suziki Y， Abe N， et al. Management of intraductal papillary mucinous neoplasm of the pancreas [J]. J Gastroenterol，2008， 43(3)：181-185.

1. Fitzgerald TL， Hickner ZJ， Schmitz M， et al. Changing incidence of pancreatic neoplasms：a 16-year review of statewide tumor registry [J]. Pancreas， 2008， 37(2)：134-138.
2. Kloppel G， Kosmahl M. Cystic lesions and neoplasms of the pancreas. The features are becoming clearer [J]. Pancreatology，2001， 1(6)：648-655.
3. Adsay NV. Cystic neoplasia of the pancreas： pathology and biology [J]. J Gastrointest Surg， 2008， 12(3)：401-404.
4. Federle MP， McGrath KM. Cystic neoplasms of the pancreas [J]. Gastroenterol Clin North Am， 2007， 36(2)：365-376.
5. 王亚军，孙家邦. 胰腺囊性肿瘤的诊治体会 [J]. 临床肝胆病杂志， 2010， 26(5)：472-475.
6. Allen PJ， Brennam MF. The management of cystic lesions of the pancreas [J]. Adv Surg， 2007， 41(2)： 211-228.
7. Paye F， Sauvanet A， Terris B. Intraductal papillary mucinous tumors of the pancreas：pancreatic resections guided by preoperative morphological assessment and intraoperative frozen section examination [J]. Surgery， 2000， 127(5)：536-544.
8. Galanis C， Zamani A， Cameron JL， et al. Resected serous cystic neoplasms of the pancreas：a review of 158 patients with recommendations for treatment [J]. J Gastrointest Surg， 2007， 11(7)：820-826.
9. Yamaguchi K， Kanemitsu S， Hatori T， et al. Pancreatic ductal adenocarcinoma derived from IPMN and pancreatic ductal adenocarcinoma concomitant with IPMN [J]. Pancreas， 2011， 40(4)：571-580.
10. Llatas J， Palomino A， Frisancho O. Frantz tumor：a pancreaticpseudopapillary solid neoplasia [J]. Rev Gastroenterol Peru，2011， 31(1)：56-60.
11. Friebe V， Keck T， Mattern D， et al. Serous cystadenocarcinoma of the pancreas： management of a rare entity [J]. Pancreas，2005， 31(2)：182-187.
12. Tseng JF， Warshaw AL， Sahani DV. Serous cystadenoma of the pancreas：tumor growth rates and recommendations for treatment[J]. Ann Surg， 2005， 242(3)：413-419.
13. Brugge WR， Lauwers GY， Sahani D， et al. Cystic neoplasms of the pancreas [J]. N Engl J Med， 2004， 351(12)：1218-1226.
14. Bassi C， Salvia R， Molinari E， et al. Management of 100 consecutive cases of pancreatic serous cystadenoma：wait for symptoms and see at imaging or vice-versa?[J]. World J Surg， 2003，27(3)：319-323.
15. Society for Surgery of the Alimentary Tract. SSAT patient care guidelines. Cystic neoplasms of the pancreas [J]. J Gastrointest Surg， 2007， 11(9)：1225-1227.
16. 孙备，陈华. 胰腺癌外科治疗的现状与展望 [J]. 中国普外基础与临床杂志， 2008， 15(8)：547-549.
17. 陈天宇，孙家邦. 胰腺实性假乳头状瘤8 例临床报道 [J]. 首都医科大学学报， 2006， 27(3)：391-394.
18. 张益军，翁永强，袁祖荣. 胰腺实性假乳头状瘤临床治疗体会 [J]. 中国普外基础与临床杂志， 2010， 17(6)：611-612.
19. 陈磊，曹苇，赵鑫，等. 胰腺实性假乳头状瘤诊治分析( 附8例报道) [J]. 中国普外基础与临床杂志， 2011， 18(7)：764-766.
20. Sugiyama M， Suziki Y， Abe N， et al. Management of intraductal papillary mucinous neoplasm of the pancreas [J]. J Gastroenterol，2008， 43(3)：181-185.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Diagnosis and Treatment of Pancreatic Cystic Tumors

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