Spectrum of Cystic Neoplasms of the Pancreas and Their Surgical Management

Sheehan, Maureen K.

doi:10.1001/archsurg.138.6.657

Cited by 56 publications

(48 citation statements)

References 24 publications

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“…Sixty percent of cases in this group were cystic neoplasm. Though in many series of cystic neoplasm of pancreas spleen was not preserved, some series attempted it with favorable outcome [25,26].…”

Section: Discussionmentioning

confidence: 99%

Spleen-Preserving Versus Spleen-Sacrificing Distal Pancreatectomy in Laparoscopy and Open Method-Perioperative Outcome Analysis—14 Years Experience

et al. 2015

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We analyzed perioperative outcome of distal pancreatectomies with or without splenic preservation both in laparoscopic and open method to determine best approach. Retrospective data was collected from 1999 to 2013. We divided all distal pancreatectomies into four groups. Group 1-laparoscopic spleen-preserving distal pancreatectomy (LSPDP). Group 2-laparoscopic splenectomy + distal pancreatectomy (LSDP). Group 3-open spleen-preserving distal pancreatectomy. Group 4-open splenectomy + distal pancreatectomy. We recorded demographic data, intra and post operative complications, operative time, estimated blood loss, length of stay, pancreatic leak rate, and final pathology result. A total of 38 distal pancreatectomies were included. In group 1, patients were significantly younger (mean 29 vs 47 to 50 in other groups, p=0.014). Tumor size (average 2.5 vs 5 to 9.5 cm in other groups, p=0.023) and operative time (average 98 min vs 125 to 141 in other groups, p=0.004) and hospital stay (average 6 vs 8 to 19 days in other groups, p=0.009) in LSPDP were all significantly less than other groups taken together. However, intra-operative blood loss was equivalent. We further analyzed that between LSPDP and LSDP, age and tumor size were significantly less in LSPDP. Further we analyzed between spleen-preserving (groups 1+3) vs spleensacrificing (groups 2+4) distal pancreatectomies and between overall laparoscopic (groups 1+2) vs open (groups 3+4). Laparoscopic spleen-preserving distal pancreatectomy has all the advantages of minimal access surgery especially in small lesions and low-grade malignancy.

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Section: Discussionmentioning

confidence: 99%

Spleen-Preserving Versus Spleen-Sacrificing Distal Pancreatectomy in Laparoscopy and Open Method-Perioperative Outcome Analysis—14 Years Experience

et al. 2015

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“…In a study done by Loyola University, 5 out of 20 MCN patients had mucinous cystadenocarcinoma (Sheehan et al, 2003). Distal pancreatectomy was performed in four patients and one pancreatoduodenectomy was done, without any mortality (Sheehan et al, 2003). In mucinous cystic adenoma, most patients had a distal pancreatectomy performed and the mortality was 0% in this study (Sheehan et al, 2003).…”

Section: Surgerymentioning

confidence: 60%

“…It has a number of benefits, including long term survival of patients, relief of symptoms, and diagnostic certainty (Roggin et al, 2010). A study showed that out of 73 patients with PCN who underwent surgery, 70 patients survived and had a low rate of surgical complications (Sheehan et al, 2003). Management of patients with PCNs depends on whether the lesions are mucinous or non-mucinous.…”

Section: Surgerymentioning

confidence: 99%

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Pancreatic cystic neoplasms: a review of preoperative diagnosis and management

Bai

Zhang

Masood

et al. 2013

J. Zhejiang Univ. Sci. B

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Pancreatic cystic neoplasms (PCNs) are a diverse group of neoplasms in the pancreas, and are more increasingly encountered with widespread abdominal screening and improved imaging techniques. The most common types of PCNs are serous cystic neoplasms (SCNs), mucinous cystic neoplasms (MCNs), and intraductal papillary mucinous neoplasms (IPMNs). Clinicians frequently feel bewildered in the differential diagnosis and subsequent management among the various types of lesions in the pancreas, which may lead to overtreatment or delayed treatment. The current review provides recent developments in the understanding of the three most common types of PCNs, the latest modalities used in preoperative diagnosis and differential diagnosis, as well as the most up to date management. Suggestions for diagnosis and differential diagnosis of SCNs, MCNs, and IPMNs are also provided for young surgeons. Better understanding of these neoplasms is essential for clinicians to make accurate diagnosis and to provide the best management for patients.

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“…14 The most common complication of the surgical resection is a pancreatic-duct fistula, which occurs in about 10% of cases. 18 Though EUS guided CFA may help to differentiate benign diseases from malignant ones, the morbidity of the cystic puncture is not zero. It has been reported to be from 1% to 4%.…”

Section: Discussionmentioning

confidence: 99%

A Case of Pancreatic Pseudocyst with an Atypical Multilocular Appearance on Endoscopic Ultrasound

Park¹,

Jung²,

Cho³

et al. 2010

Gut Liver

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Pancreatic pseudocysts are focal fluid collections that develop as a result of inflammatory diseases of the pancreas. They are managed conservatively or with a drainage procedure. Their radiological appearance can mimic cystic neoplasms of the pancreas. Pancreatic cystic neoplasms include various neoplasms with a wide range of malignant potential. Here, we report a patient with a pancreatic pseudocyst that presented with macrocystic attributes on endoscopic ultrasound.

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Spectrum of Cystic Neoplasms of the Pancreas and Their Surgical Management

Cited by 56 publications

References 24 publications

Spleen-Preserving Versus Spleen-Sacrificing Distal Pancreatectomy in Laparoscopy and Open Method-Perioperative Outcome Analysis—14 Years Experience

Spleen-Preserving Versus Spleen-Sacrificing Distal Pancreatectomy in Laparoscopy and Open Method-Perioperative Outcome Analysis—14 Years Experience

Pancreatic cystic neoplasms: a review of preoperative diagnosis and management

A Case of Pancreatic Pseudocyst with an Atypical Multilocular Appearance on Endoscopic Ultrasound

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