Incidence and reasons of pancreatic resection in patients with asymptomatic serous cystadenoma
Incidence and reasons of pancreatic resection in patients with asymptomatic serous cystadenoma
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DOI：
10.1016/j.pan.2018.06.001
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发表时间：
2018-07-01
期刊：
影响因子：
3.6
通讯作者：
Boggi, Ugo
中科院分区：
文献类型：
--
作者：
Lombardo, Carlo;Iacopi, Sara;Boggi, Ugo
背景/目的：尽管诊断上有所改进，但一些无症状浆液性囊腺瘤（A-SCA）患者最终仍需行胰腺切除术（PR）。方法：回顾性分析2005年1月至2016年3月期间因胰腺囊性病变（PCL）转诊的所有患者的前瞻性数据库。结果：共有1488例PCL患者，其中1271例（85.4%）为偶发PCL（I-PCL）。在研究期间，I-PCL的转诊增加了8.5倍。在94例I-PCL（7.3%）中立即建议手术，后来在另外11例患者（0.9%）中由于症状的发展而必须手术。总体而言，在105/1271例I-PCL患者（8.2%）中进行了PR，包括27例A-SCA患者（2.1%）。所有A-SCA患者均接受超声检查和对比增强计算机断层扫描。21例患者（77.8%）进行了磁共振成像，8例（29.6%）进行了18 F-FDG正电子发射断层扫描，2例（7.4%）进行了内镜超声检查（EUS），1例（3.7%）进行了EUS引导下细针穿刺（EUS-FNA）。这些研究显示了非典型特征的组合，例如实体瘤（3; 11.1%）、寡/巨囊性肿瘤（24; 88.8%）、壁结节（14; 51.8%）、囊壁增强（17; 62.9%）、主胰管扩张（3; 11.1%）和上游胰腺萎缩（1; 3.7%）。此外，14/27例（51.8%）是女性与寡/巨囊性肿瘤位于体尾的pancreat.Conclusions：管理A-SCA患者需要PR的风险很小，特别是当这些肿瘤表现出非典型的放射学特征与混淆的解剖和人口统计学特征。(C)2018年IAP和EPC。Elsevier B. V.出版，保留所有权利。
Background/Objectives: Despite diagnostic refinements, pancreatic resection (PR) is eventually performed in some patients with asymptomatic serous cystadenoma (A-SCA). The aim of this study was to define incidence and reasons of PR in A-SCA.Methods: A retrospective analysis of a prospectively maintained database was performed for all the patients referred for pancreatic cystic lesions (PCL) between January 2005 and March 2016.Results: Overall, there were 1488 patients with PCL, including 1271 (85.4%) with incidental PCL (I-PCL). During the study period referral of I-PCL increased 8.5-fold. Surgery was immediately advised in 94 I-PCL (7.3%) and became necessary later on in 11 additional patients (0.9%), because of the development of symptoms. Overall, PR was performed in 105/1271 patients presenting with I-PCL (8.2%), including 27 with A-SCA (2.1%). All patients with A-SCA underwent ultrasonography and contrast-enhanced computed tomography. Magnetic resonance imaging was performed in 21 patients (77.8%), 18 F-FDG positron emission tomography in 8 (29.6%), endoscopic ultrasonography (EUS) in 2 (7.4%), and EUS-guided fine needle aspiration (EUS-FNA) in 1 (3.7%). These studies demonstrated a combination of atypical features such as solid tumor (3; 11.1%), oligo-/macrocystic tumor (24; 88.8%), mural nodules (14; 51.8%), enhancing cyst walls (17; 62.9%), dilation of the main pancreatic duct (3; 11.1%), and upstream pancreatic atrophy (1; 3.7%). Additionally, 14/27 patients (51.8%) were females with oligo-/macrocystic tumors located in the body-tail of the pancreas.Conclusions: Management of patients with A-SCA entails a small risk of PR especially when these tumors demonstrate atypical radiologic features associated with confounding anatomic and demographic characteristics. (C) 2018 IAP and EPC. Published by Elsevier B.V. All rights reserved.