Multidisciplinary Management Strategy for Incidental Cystic Lesions of the Pancreas
| Autor: | Debashish Bose, Jun Liu, Jason B. Fleming, Eric P. Tamm, Douglas B. Evans, Rosa F. Hwang, Aparna Balachandran, Priya Bhosale, Leonardo P. Marcal, Jeffrey E. Lee |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Endoscopic ultrasound medicine.medical_specialty Pancreatic disease Adolescent medicine.medical_treatment Biopsy Fine-Needle Article Endosonography Diagnosis Differential Young Adult Pancreatectomy parasitic diseases medicine Humans Aged Retrospective Studies Aged 80 and over Univariate analysis medicine.diagnostic_test Intraductal papillary mucinous neoplasm business.industry Middle Aged Prognosis medicine.disease Texas Surgery medicine.anatomical_structure Fine-needle aspiration Practice Guidelines as Topic Female Radiology Pancreatic Cyst Pancreatic cysts Tomography X-Ray Computed Pancreas business Precancerous Conditions Follow-Up Studies |
| Zdroj: | Journal of the American College of Surgeons. 211:205-215 |
| ISSN: | 1072-7515 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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