Diagnosis and treatment of pancreatic cystic neoplasms

Objective To summarize the experience in diagnosis and treatment of pancreatic cystic neoplasms. Methods The clinical data of 45 patients with pancreatic cystic neoplasms treated in our hospital from 1994 to 2004 were retrospectively analyzed. Results Of the 45 patients with an average of 49. 1 years, 12 were male and 33 female. The tumors could be divided into 8 subtypes. The clinical manifestations showed no specificity. Cystic masses or cystic solid masses were found in the pancreas by ultrasonography and CT scanning. ERCP and EUS had additional value for the differentiation of cystic tumors. Local resection of tumors, Whipple procedure and distal pancreatectomy were performed in 13, 12 and 18 patients, respectively, in accordance with the tumor location and pathological features. One patient underwent total pancreatectomy and another biopsy alone. No patient died within the perioperative period. Pancreatic fistula occurred in 2 patients and it was cured by conservative management. Thirty-eight patients were followed up for an average of 32. 6 months. During the follow-up period, only 4 patients died and the others survived without relapse and metastasis. Conclusions Since there exists various pancreatic cystic neoplasms without specific symptoms, different kinds of examinations are needed to diagnose the disease. Prompt surgery is recommended for the tumors. The rate of surgical resection in high and the prognosis is satisfactory.