A Clinical Study on Cystic Neoplasms of the Pancreas

Ko, Young Hyun; Han, Duck Jong; Lee, Sung Gyu; Lee, Young Joo; Park, Kwang Min; Hwang, Shin; Lim, Duck Sang; Kim, Song Cheol

Abstract

BACKGROUND/AIMS: The aim of this study was to review the cystic neoplasms of the pancreas. METHODS: We retrospectively reviewed the clinical records of 159 patients with cystic neoplasms of the pancreas. The patients were treated surgically at the Asan Medical Center between March 1991 and May 2002. RESULTS: There were 37 serous cystadenomas (23%), 24 mucinous cystic neoplasms (15%), 38 solid and papillary epithelial neoplasms (24%), and 60 intraductal papillary mucinous tumors (38%). The most common symptom was abdominal pain. Ultrasonography and computed tomography were used for diagnosis in 63.6% and 71.6% of the patients, respectively. Regarding surgical treatments, pancreaticoduodenectomy was performed in 25 cases, pylorus preserving pancreticoduodenectomy in 42 cases, total pancreatectomy in 11 cases, distal pancreatectomy in 60 cases, spleen preserving distal pancreatectomy in 4 cases, segmental pancreatectomy in 14 cases, and local excision in 3 cases. The overall perioperative complication rate was 12%. The 32 patients had malignacy on histologic examinations. The overall 5 year survival rate was 90.8%. CONCLUSIONS: For the cystic neoplasms of the pancreas we recommend an active strategy of resection considering the high possibility of malignancy and the diagnostic difficulties. The resection has usually led to a low morbidity, low mortality, and good prognosis.