Which treatment in cystic tumors of the pancreas: conservative or resection

Author: 
Graziano Giorgio Maria Paolo

Introduction: The cystic tumors are relatively rare, considered approximately 10% of all pancreatic neoplasms. Only 1% of all cystic pancreatic tumors are malignancies. Often asymptomatic onset, develop mechanical symptoms with their progressive growth, compressing adjacent anatomical structures The purpose of the study is to, through a retrospective analysis of our patients, evaluate the indications for treatment of cystic neoplasms of the pancreas.
Materials and Methods were evaluated retrospectively 13 patients (8 females, range 58-85 years) with pancreatic cystic neoplasms observed at the Surgery Unit colo rectal from 2007-14 Policlinico Catania, in addition to 11 patients (6 males females 5 range 60-75 years) from 2008 to 2015 observed at the II clinical Surgical Hospital of Catania the main features of imaging currently adopted for the diagnosis of pancreatic cystic neoplasms include localization, intralesional cysts pattern (unilocular oligocistica, polycystic appearance) , calcifications, communication with the main pancreatic duct or side ducts, thick septa, the presence of internal or mural nodules debris. The TNM staging of cancer in Group I in n 5 cases were in stage T2MoNo, in 7 cases in stage T3 M1NX.Nel Group II in n 9 cases T3MXNX stadium and the remaining cases T4MXNX.
Results In reference to the first group of 13 patients with pancreatic cystic neoplasms. In Codest group in each patient, was adopted a different clinical approach based on different criteria: age, comorbidity, imaging characteristics, symptoms, Vitain 8 cases expectation surgical treatment was chosen resection, while in the remaining 5 cases was preferred a more conservative approach. Treatment was performed in N 4 cases, a DPC, in n2 cases a body tail resection, in one case the total pancrasectomia. In group II consisting of 11 patients, was adopted a more aggressive clinical approach based on diversified resectability criteria were: the absence of invasion axis mesenteric portal, and the absence of MTS
Discussion Surgery is currently the only treatment with curative intent, despite the claims of Gudioronsson, Di Catalto and others on the need and usefulness of a Intervet resection (1.3) Codest treatment remains the gold standard for the treatment of pancreatic ca.
Conclusions In recent years the scintigraphic techniques at immaging regard diagnostics and stanging of pancreatic tumors have been innovative and have gained a major role.

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