Surgical Management of Cystic Lesions of the Pancreas: A Single-Centre Experience

Abstract

BACKGROUND: Cystic lesions of the pancreas represent a group of pancreatic diseases with great histological heterogeneity, varying from benign lesions, some of them with malignant potential, to overt malignant lesions. OBJECTIVE: To describe the cases of cystic lesions of the pancreas which underwent surgical intervention at a tertiary university hospital. METHODS: This is a retrospective population-based study (historical cohort) which was carried out enrolling individuals attended at the Outpatient service of Pancreas Surgery of the Hospital de Clínicas of Unicamp. The individuals underwent surgical procedures performed from January 2012 through December 2016. RESULTS: In the period evaluated, 39 cases of cystic lesions of the pancreas which underwent surgery were identified, 26 (66.6%) of which were female. The average age at diagnosis was 47.4±16.4 years (range, 18-73). In regards to symptoms, 35 (89.7%) were symptomatic. The average length of hospital stay was 10 days (range 4-76). Surgeries performed to treat the lesions depended on the localization and type of the lesions: cystojejunostomy (41%), distal pancreatectomy (36%), pancreaticoduodenectomy (15.4%), drainage of ruptured and/or infected pseudocyst (5.2%) and central pancreatectomy (2.6%). CONCLUSION: Cystic lesions of the pancreas are a group of lesions with a highly varying presentation and diagnostic approach and may require an also highly variable surgical treatment. An appropriate preoperative imaging diagnosis is essential for their management.

Síndrome de mccune albright, neoplasia papilar mucinosa intraductal e carcinoma colóide: Um relato de caso de apresentação concomitante / Mccune albright syndrome, intraductal mucin papillary neoplasia and colloid carcinoma: A concomiting presentation case report

“…Apesar de representarem uma pequena parte do grupo de lesões, os tumores císticos pancreáticos são responsáveis por um número considerável de indicações de cirurgias pancreáticas. É de extrema importância reconhecer as características das lesões e seu comportamento para um diagnóstico com exatidão, além disso quando está associado à síndromes torna-se ainda mais complexo, sem dúvidas é um desafio para o cirurgião [13].…”

Pancreaticoduodenectomy With Venous Resection: An Analysis of 30-Day Morbidity and Mortality

“…It was observed, mainly, that a more precarious clinical status assessed by both ASA and ECOG scores was associated with a higher mortality, as previously pointed out by Chou et al (31) The socioeconomic profile of patients in our country is strongly reflected in terms of nutritional status and access to health services. Thus, these are patients whose diagnosis is very late and who, in most cases, are admitted with clinical and nutritional conditions already significantly deteriorated in the referral service (32,33) . There is strong evidence that the results of general and oncologic surgical treatments for pancreatic cancer are significantly worse in populations with more precarious socioeconomic status due to issues such as a difficulty to access referral services and their generally deteriorated health status (34)(35)(36) .…”

Non-inflammatory pancreatic cysts: from diagnosis to treatment (97 cases series)

“…In addition, even today surgical treatment is still associated with significant morbidity and mortality 6 . When analyzing the Brazilian national scenario, there are only few studies on the subject, usually based on case reports 7 , already operated case series 8,9 , or case series submitted to some specific exam and no appropriate clinical or radiological follow-up 10 . The objective of this study was to evaluate a consecutive series of patients seeking the clinic of digestive tract diseases with pancreatic cyst, whose diagnosis of pseudocyst was ruled out and the one of pancreatic cystic neoplasia (PCN) was most likely.…”