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June 2003

Spectrum of Cystic Neoplasms of the Pancreas and Their Surgical Management

Author Affiliations

From the Section of Surgical Oncology, Department of Surgery, Loyola University Medical Center, Maywood, Ill.

Arch Surg. 2003;138(6):657-662. doi:10.1001/archsurg.138.6.657

Background  Owing to increased awareness and the widespread use of abdominal ultrasonography and computed tomography, an increasing number of cystic neoplasms are being identified. Cystic neoplasms of the pancreas are divided into the following 4 main groups: serous cystic neoplasms, mucinous cystic neoplasms, solid pseudopapillary neoplasms, and intraductal pancreatic mucinous neoplasms.

Objective  To review our experience with cystic neoplasms of the pancreas at our institution from January 1992 through September 2002.

Methods  Medical records were reviewed for age, sex, clinical signs and symptoms, diagnosis, surgical treatment, morbidity, mortality, and histologic features.

Results  Seventy-three patients (49 women and 24 men) underwent surgical resection of a cystic neoplasm of the pancreas from January 1992 through September 2002. The most common presenting symptom was abdominal pain. Other symptoms included nausea, emesis, weight loss, jaundice, and pancreatitis. Most patients (73%) had no complications. The most common complication (10%) was pancreatic fistula. There were 3 deaths.

Conclusions  Cystic neoplasms of the pancreas are an increasing entity. Long-term survival of patients with these tumors is generally better than that of patients with adenocarcinoma of the pancreas and mandates aggressive resectional therapy in most patients. Resection of these tumors can be done with resultant low morbidity and mortality rates.