Multidisciplinary management strategy for incidental cystic lesions of the pancreas. J Am Coll Surg 2010 Aug;211(2):205-15
Date
07/31/2010Pubmed ID
20670858Pubmed Central ID
PMC4174396DOI
10.1016/j.jamcollsurg.2010.03.034Scopus ID
2-s2.0-77955560948 (requires institutional sign-in at Scopus site) 28 CitationsAbstract
BACKGROUND: At our institution, incidental pancreatic cysts are frequently identified in asymptomatic patients undergoing routine imaging for staging of nonpancreatic malignancies. Management of these patients is unclear because a small but significant number of incidental pancreatic cysts are malignant.
STUDY DESIGN: Our institutional database was reviewed for patients with ICD-9 codes for pancreatic cysts from 1980 to 2005. Clinicopathologic factors, including CT and endoscopic ultrasound (EUS) characteristics and management strategies, were analyzed.
RESULTS: Over 25 years, 942 patients were identified with pancreatic cysts. Excluding those with symptoms or pseudocysts, 350 patients remained with incidental pancreatic cysts. Mean overall survival was 41.4 months (mean follow-up 32.7 months). Forty-one patients underwent resection, of whom 38 (92.7%) had premalignant or malignant pathology. Univariate analysis of variables predicting pathologic premalignant or malignant diagnosis identified pancreatic neck or body location as significant factors.
CONCLUSIONS: These data suggest that most incidental pancreatic cysts can be managed nonoperatively using a selective strategy based on detailed review of CT imaging and EUS findings.
Author List
Bose D, Tamm E, Liu J, Marcal L, Balachandran A, Bhosale P, Fleming JB, Lee JE, Evans DB, Hwang RFAuthor
Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Biopsy, Fine-Needle
Diagnosis, Differential
Endosonography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pancreatectomy
Pancreatic Cyst
Practice Guidelines as Topic
Precancerous Conditions
Prognosis
Retrospective Studies
Texas
Tomography, X-Ray Computed
Young Adult
