Examination of pancreatic cystic neoplasm except IPMN who underwent surgical resection in our department

Abstract

Background: These days, detection of cystic neoplasm of the pancreas has been increasing because of improvement for image-diagnosis and substantiality for health examination. We retrospectively analyzed the disease except IPMN in our department. 32 cases were enrolled in this study. Age: 51 years in median (24-80), Gender: 8 men, 23 females, Main lesions in the pancreas were located in head / body / tail; 9 / 10 / 12, The size of tumor: 55 mm in median (8-140). Distant metastases (yes/no) were (3/28). Follow-up period was 55 months (7-130). Results: 1. Symptom were examined in 13 cases, abdominal pain in 11, abdominal discomfort in 2, no symptom in 19. 2. The preoperative diagnosis was pathologically obtained in 4 cases by EUS-FNA, all of those were SPN. 3. Distal pancreatectomy was performed in 18 cases (laparoscopic surgery in 15), pancreaticoduodenectomy in 8, central pancreatectomy in 4, total pancreatectomy in 1. 4. Bleeding volume was 640 ml (0-1510) and operation time was 465 minutes (224 - 844). 5. Discrepancy between preoperative and final diagnosis occurred in 8 cases (26%) Among them, final diagnosis was MCN in 3, epidermoid cyst in 2, SCN, squamoid cyst, hamartoma in 1, respectively. 6. Recurrence and metastasis: LN metastasis occurred in 2 cases (simultaneous in 1 SPN, 3 years after 1 ITN surgery), multiple liver metastasis in 2 (simultaneous and 1 year after operation in SPN). Conclusion: Exact diagnosis for pancreatic cystic disease except IPMN is very important because of that with malignant potential.