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2013 ; 13
(54
): 263-81
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Diagnosis and treatment of pancreatic pseudocysts and cystic tumors based on own
material and quoted literature
#MMPMID26673675
?wik G
; Krupski W
; Zako?cielny A
; Wallner G
J Ultrason
2013[Sep]; 13
(54
): 263-81
PMID26673675
show ga
Pseudocysts constitute the most basic cystic lesions of the pancreas. Symptomatic
cysts may be treated by means of both minimally invasive methods and surgery.
Currently, it is believed that approximately 5% of cystic lesions in the pancreas
may in fact, be neoplastic cystic tumors. Their presence is manifested by
generally irregular multilocular structures, solid nodules inside the cyst or in
the pancreatic duct, frequently vascularized, as well as fragmentary thickening
of the cystic wall or septation. AIM: The aim of this paper was to present
current management, both diagnostic and therapeutic, in patients with pancreatic
pseudocysts and cystic tumors. The article has been written based on the material
collected and prepared in the author's Department as well as on the basis of
current reports found in the quoted literature. MATERIAL AND METHODS RESULTS: In
2000-2012, the Second Department of General, Gastrointestinal and Oncological
Surgery of the Alimentary Tract treated 179 patients with cystic lesions in the
region of the pancreas. This group comprised 12 cases of cystic tumors and 167
pseudocysts. Twenty-three patients (13.8%) were monitored only and 144 received
procedural treatment. Out of the latter group, 75 patients underwent drainage
procedures and 48 were qualified to endoscopic cystogastrostomy or
cystoduodenostomy. The endoscopic procedure was unsuccessful in 11 cases (23%).
In a group of patients with a pancreatic cystic tumor (12 patients), 6 of them
(50%) underwent therapeutic resection of the tumor with adequate fragment of the
gland. CONCLUSIONS: Endoscopic drainage is an effective and safe method of
minimally invasive treatment of pancreatic cysts. The patients who do not qualify
to endoscopic procedures require surgical treatment. The differentiation of a
neoplasm from a typical cyst is of fundamental significance for the selection of
the treatment method.