Diagnosis And Treatment Of Pancreatic Cystic Neoplasms Retrospective Analysis Of134Cases

Objective:Through analysis of the issues related with diagnosis and treatmentof pancreatic cystic neoplasms, to investigate the diagnostic criteria，indications for surgery and surgical procedure for the patients withpancreatic cystic neoplasms.Methods:Retrospective analysis of clinical data and postoperative follow-upof patients with pancreatic cystic neoplasms survey from November2005to December2013in our hospital，by surgical resection a total of134cases. According to the result of differences in pathology, discuss surgicaltreatment of pancreatic cystic neoplasms, postoperative and long-termcomplications, quality of life and survival time.Results:134cases of patients with pancreatic cystic neoplasms, including38cases of SCN，31cases of MCN，24cases of IPMN and41cases ofSPN. non-specific clinical manifestation was observed, Laboratory testswere no significant abnormalities.90.3%,94.1%and93.3%accuracycan be achieved by ultrasound, CT and MRI on the diagnosis ofpancreatic cystic neoplasms respectively. In postoperativeimmunohistochemical examination of11cases,10cases expressVimentin (+), the expression of NSE is also10/11. Due to the growthsites of pancreatic cystic neoplasms, difference of benign or malignanttumors, you can choose a different surgical procedure, the distal pancreatectomy with splenectomy in55cases, laparoscopic distalpancreatectomy with splenectomy in3cases, spleen-preserving distalpancreatectomy in14cases; pancreaticoduodenectomy in39cases,duodenum-preserving proximal pancreatectomy in2cases; middlepancreatectomy in12cases; enucleation in9cases. The incidence ofpostoperative pancreatic fistula of pancreatic cystic tumors, secondaryhyperglycemia (fasting venous plasma glucose>11.1mmol/L) andabdominal infection was32.8%,14.2%and14.7%, respectively. The long-term complications occurred in a patient after duodenum-preservingproximal pancreatectomy. in2patients occurred perioperative mortality.All the cases of SCN, SPN, non-invasive MCN and IPMN survied5yearslong, while the5-year survival rates of invasive MCN and IPMN were37.5%and28.6%.Conclusion:1, Women were common in pancreatic cystic neoplasms, non-specificclinical manifestations, detection rate was high in imaging, especially CTand MRI play an important role in the pre-operative diagnosis ofpancreatic cystic neoplasms, but still histologic classification need to beused of cytological and pathological identification.2, According to the results of pancreatic cystic tumor size, growth area,the relationship with the surrounding tissue, intraoperative rapidpathology decided on the specific surgical procedure, to preserve normalpancreatic tissue as soon as possible.3, Although the higher incidence of postoperative pancreatic fistula,the long-term impact on the internal and external secretory function is small, so segmental pancreatectomy is worthy of recommendation.