Pancreatic Cystic Lesions: When to Watch, When to Operate, and When to Ignore

Turner, Brian G.; Brugge, William R.

doi:10.1007/s11894-010-0097-0

Cited by 23 publications

(14 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[1–3] Pancreatic cystic lesions are being increasingly identified with the widespread use of advanced radiological techniques. [4] The incidence of pancreatic cysts (PC) has been estimated to be between 1% and 2% in patients who had a computed tomography (CT)/magnetic resonance (MRI) imaging performed. [56]…”

mentioning

confidence: 99%

Pancreatic cystic neoplasms: Predictors of malignant behavior and management

Atef

Nakeeb

Hanafy

et al. 2013

Saudi J Gastroenterol

View full text Add to dashboard Cite

Background/Aim:Pancreatic cystic neoplasms are being increasingly identified with the widespread use of advanced imaging techniques. In the absence of a good radiologic or pathologic test to preoperatively determine the dianosis, clinical characteristics might be helpful. The objectives of this analysis were to define the incidence and predictors of malignancy in pancreatic cysts.Patients and Methods:Patients with true pancreatic cysts who were treated at our institution were included. Patients with documented pseudocysts were excluded. Demographic data, clinical manifestations, radiological, surgical, and pathological records of those patients were reviewed.Results:Eighty-one patients had true pancreatic cyst. The mean age was 47 ± 15.5 years. There were 28.4% serous cystadenoma, 21% mucinous cystadenoma, 6.2% intraductal papillary tumors, 8.6% solid pseudopapillary tumors, 1.2% neuroendocrinal tumor, 3.7% ductal adenocarcinoma, and 30.9% mucinous cystadenocarcinoma. Malignancy was significantly associated with men (P = 0.04), older age (0.0001), cysts larger than 3 cm in diameter (P = 0.001), presence of solid component (P = 0.0001), and cyst wall thickening (P = 0.0001). The majority of patients with malignancy were symptomatic (26/28, 92.9%). The symptoms that correlated with malignancy included abdominal pain (P = 0.04) and weight loss (P = 0.0001). Surgical procedures were based on the location and extension of the lesion.Conclusion:The most common pancreatic cysts were serous and mucinous cysts. These tumors were more common in females. Old age, male gender, large tumor, presence of solid component, wall thickness, and presence of symptoms may predict malignancy in the cyst.

show abstract

mentioning

confidence: 99%

Pancreatic cystic neoplasms: Predictors of malignant behavior and management

Atef

Nakeeb

Hanafy

et al. 2013

Saudi J Gastroenterol

View full text Add to dashboard Cite

show abstract

“…Without a constant source of fluid from a ductal epithelium, pseudocysts may spontaneously resolve. Small pseudocysts, less than 4 cm in diameter, often resolve and are rarely associated with complications, although larger cysts are generally more likely to become symptomatic or cause complications (18) (Fig. 5B).…”

Section: Managementmentioning

confidence: 99%

“…5B). Forty percent of the pseudocysts less than 6 cm and approximately the half of the pseudocysts larger than 6 cm will require drainage because of complications or persistence (18). Drainage of pancreatic pseudocysts may be accomplished with a variety of procedures (19).…”

Section: Managementmentioning

confidence: 99%

Pancreatic Cystic Lesions: Diagnostic, Management and Indications for Operation. Part I

Bauer¹

2017

chr

View full text Add to dashboard Cite

Chirurgia, 112 (2), 2017 97 RezumatÎn ultimele trei decenii am observat o creştere a frecvenţei depistării şi evaluării leziunilor chistice pancreatice (PCL). Acestea prezintă o paletă variată de trăsături imagistice şi clinice. Diagnosticul şi diferenţierea leziunilor chistice pancreatice este deosebit de importantă, din cauza riscului concret de malignizare. Principalul motiv al acestei lucrari este conştientizarea existenţei acestor leziuni şi folosirea extinsă a modalităţilor imagistice cu secţiuni transversale, tehnică aflată într-o continuă dezvoltare (1). De obicei, PCL sunt diagnosticate din întâmplare în timpul investigării unor dureri abdominale independente şi nespecifice folosind proceduri imagistice obişnuite, CT sau IRM. Leziunile chistice pancreatice reprezintă o colecţie eterogenă histologică, care poate avea un spectru larg de diagnostice de la complet benign la potenţial malign, la carcinom in situ şi până la invaziv (2,3). În 1978, Compagno şi Oertel au fost primii care au observat distincţia crucială între neoplaziile chistice seroase şi mucinoase ale pancreasului şi au explicat importanţa identificării neoplaziilor mucinoase din cauza potenţialului lor malign latent sau evident (4,5). De atunci, interesul pentru PCL a crescut semnificativ, mai ales după ce a fost identificată importanţa şi prevalenţa neoplaziilor papilare mucinoase intraductale (IPMN). În prezent, PCL reprezintă o provocare frecventă şi dificilă în practica clinică, datorită creşterii detectării acestora la pacienţi asimptomatici şi a lipsei de înţelegere a aspectelor care ţin de comportamentul biologic al acestor neoplazii. Diferenţele importante în ceea ce priveşte rezultatul lor final şi identificarea acestora tot mai frecventă au plasat neoplaziile în atenţia chirurgilor, anatomopatologilor, gastroenterologilor, Abbreviations:

show abstract

“…1) [3]. Differenzialdiagnostisch kommen Retentionszysten, seröse Zystadenome, muzinöse Neoplasien und intraduktale papilläre muzinöse Neoplasien (IPMN) infrage [4]. table 2 veranschaulicht die wichtigsten diagnostischen Kriterien.…”

Section: Differenzialdiagnoseunclassified

Endoskopische Drainage von Pankreaspseudozysten

Denzer¹,

Rösch²

2012

Visc Med

View full text Add to dashboard Cite

Hintergrund: Die Pankreaspseudozyste ist eine häufige Komplikation der akuten oder chronischen Pankreatitis. Bei symptomatischer Zyste mit Vorliegen von abdominellen Schmerzen, einer Magenausgangsstenose, Gewichtsverlust, Ikterus, Infektion oder Größenzunahme stellt die endoskopische Drainage (transpapillär und/ oder transmural) eine effektive Erstlinientherapie dar. Methode: Die Übersicht basiert auf einer strukturierten Analyse der aktuellen, in Pubmed gelisteten Studien. Ergebnisse: Die Langzeitregressionsraten liegen bei 71–90%; die Komplikationsrate beträgt 3–35% mit einer geringen Mortalität von 0–1%. Die wesentlichen Komplikationen der endoskopischen Pseudozystendrainage sind Blutungen in bis zu 9%, Infektionen in bis zu 8%, retroperitoneale Perforation in bis zu 5% und Zystenrekurrenz in bis zu 14% der Fälle. Differenziert zu betrachten sind die infizierte Nekrose und der Pankreasabszess (walled-off necrosis) nach akuter Pankreatitis. In diesen Fällen ist die endoskopische Therapie technisch komplexer und im Vergleich zur unkomplizierten Pankreaspseudozyste mit höherer Morbidität und geringerem Langzeitansprechen verbunden. Dennoch stellt die endoskopische Drainage bei technischer Machbarkeit für beide Entitäten die Methode der ersten Wahl dar. Dies basiert insbesondere auf der nach aktuellen Daten geringeren Morbidität der Methode im Vergleich zu chirurgischen Drainageverfahren. Schlussfolgerung: Der vorliegende Review gibt einen Überblick über Therapieindikation und Differenzialdiagnose von Pankreaspseudozysten, erläutert die Drainagetechniken und stellt die Daten zu Effektivität und Komplikationen der endoskopischen Zystendrainage umfassend dar.

show abstract

Pancreatic Cystic Lesions: When to Watch, When to Operate, and When to Ignore

Cited by 23 publications

References 41 publications

Pancreatic cystic neoplasms: Predictors of malignant behavior and management

Pancreatic cystic neoplasms: Predictors of malignant behavior and management

Pancreatic Cystic Lesions: Diagnostic, Management and Indications for Operation. Part I

Endoskopische Drainage von Pankreaspseudozysten

Contact Info

Product

Resources

About