[The diagnosis and therapy of pancreatic cystic tumors].

OBJECTIVE

To discuss the surgical option and the treatment of complications of pancreatic cystic tumors.

METHODS

From January 1997 to December 2009, 32 patients with pancreatic cystic tumors in our center were reviewed retrospectively. There were 6 male and 26 female, aging from 24 to 76 years. Of the 32 patients, 16 patients had serous cystadenoma, 9 patients had mucinous cystadenoma; 1 patients had mucinous cystadenocarcinoma; 4 patients had intraductal papillary mucinous neoplasms and 3 patients had pancreatic solid pseudopapillary neoplasms. Tumor located in pancreatic head in 12 patients and in pancreatic body and tail in 20 patients.

RESULTS

All patients received surgical treatment and there was no perioperative death. Pancreato-duodenectomy was performed in 10 patients, duodenum-preserving pancreatic head resection in 1 patient, distal pancreactomy in 13 patients, including laparoscopic distal pancreactomy in 2 patients, pancreatic tumor resection in 3 patients, middle segmental resection in 4 patients; 1 patients with mucinous cystadenocarcinoma received palliative surgery. Complication included gastroparesis in 3 patients and pancreatic fistula in 5 patients, and all recovered by conservative treatment. These 29 patients were followed up 4 - 120 months, 3 patients died from tumor metastasis or other disease within 4 to 34 months after surgery. Others were alive and there was no tumor recurrence or metastasis.

CONCLUSIONS

CT scan should be the first choice of non-invasive examination for cystic pancreatic diagnosis. Positive and timely operation should be performed in the patient with cystic pancreatic tumor, and it acts as a cancer preventive treatment. The selection of surgical approach should be individualized, the principal of damage control surgery should be followed. Complications such as gastroparesis and pancreatic fistula should be paid more attention.