cystic tumours of the pancreas – a rare and diverse type of tumours胰腺囊性肿瘤的u2014u2014一种罕见的和不同类型的肿瘤.pdfVIP

Journal of Cancer Therapy, 2012, 3, 222-229 /10.4236/jct.2012.34032 Published Online August 2012 (http://www.SciRP.org/journal/jct) Cystic Tumours of the Pancreas—A Rare and Diverse Type of Tumours 1 1,2 Dag Hoem , Asgaut Viste 1Department of Surgery, Haukeland University Hospital, Bergen, Norway; 2Department of Surgical Sciences, University of Bergen, Bergen, Norway. Email: Dag.Hoem@helse-bergen.no Received May 18th, 2012; revised June 22nd, 2012; accepted July 5th, 2012 ABSTRACT Objective: Increasing incidence of non-inflammatory cystic lesions of the pancreas challenges work-up algorithms, surgery and surveillance. We have reviewed our experience with these tumours in accordance with International Con- sensus Guidelines and evaluated the outcome. Patients and Methods: From 1999 to 2009, 34 cases referred to Hauke- land University Hospital were operated upon; ten were serous (SCN), twenty-one IPMNs, one MCN, and two solid pseudopapillary neoplasms (SPPN). A thorough medical history was supplemented by CT, MRI, and US before each case were discussed in a MDT to decide on the best subsequent care. Results: All SCN and SPPN patients had benign histopathology, and no deaths were reported. Survival for malignant IPMN was, 2 years: 75%, and 5 years: 67%, where after no deaths were registered in the observation period. Presence of jaundice had the highest impact on survival (p = 0.0009), followed by weight loss (p = 0.005) and dilatation of the common bile duct (p = 0.04). In the IPMN group two had pancreatic juice leakage, and reoperation was performed in one. Conclusions: All SCN turned out benign which justify a high threshold for resection unless unacceptable symptoms dominate. For branch duct IPMNs resections of asymptomatic and smaller lesions (3 cm) should be avoided but kept under surveillance, whereas symptomatic and lager lesions together with main d