Diagnosis And Treatment Of Pancreatic Cystic Neoplasms Retrospective Analysis Of 120 Cases

Objective:To review our experience in the diagnosis and treatment of pancreatic cystic neoplasms(PCN).Methods:Retrospective analysis of clinical data and postoperative follow-up of patients with pancreatic cystic neoplasms survey from November 2003 to December 2014 in Shandong provincial hospital,by surgical resection a total of 120 cases. According to the result of differences in pathology, discuss surgical treatment of pancreatic cystic neoplasms, postoperative and long-term complications, quality of life and survival time.Results:120 cases of patients with pancreatic cystic neoplasms, including 34 cases of SCN, 28 cases of MCN,9 cases of IPMN and 49 cases of SPN.The male-to-female ratio was 1:4.22.The average age of diease onset was 45.8 years old.Non-specific clinical manifestation was observed,.120 cases of patients with pancreatic cystic neoplasms, 30.83%(n=37) of them had no symptom at diagnosis.Among symptomatic ones there were stomach ache and it was 42.5%(n=51).Location in body and tailpancreas was 62.5% and solitary was 96.7%.Laboratory tests were no significant abnormalities. 84.17%,90.83% and 88.71% accuracy can be achieved by ultrasound, CT and MRI on the diagnosis of pancreatic cystic neoplasms respectively. Due to the growth sites of pancreatic cystic neoplasms, difference of benign or malignant tumors, you can choose a different surgical procedure, the distalpancreatectomy with splenectomy in 36 cases, laparoscopic distal pancreatectomy with splenectomy in 3 cases, spleen-preserving distal pancreatectomy in 132cases, pancreaticoduodenectomy in 25 cases,duodenum-preserving proximal pancreatectomy in 3 cases, middlepancreatectomy in 11 cases,enucleation in 25 cases,palliative resection in 5 cases.The incidence of postoperative pancreatic fistula of pancreatic cystic tumors, abdominal infection and gastroparesis was 32.8%,14.2% and 14.7%, respectively. No death was in perioperative period. The 5-year survival rate of benign PCNs was 100%.The 1,3,5-year survival rate of resected malignant suegery was 68.4%,52.6%,36.8%,respectively. However, the survival rate of those undergoing palliative suegery was very low.Conclusion:1.PCNs are more common in middle aged females, among them SPN is more common in young women.PCN has no specific clinical symptoms, the majority of patients were with abdominal pain with or without abdominal discomfort and health examination before treatment.2.More than half of PCN were located in the body and tail of the pancreas of PCN and most are the single tumor, they had not serum tumor specific markers, abdominal ultrasound, CT, MRI and other conventional imaging with high accuracy, but its diagnosis depends on the comprehensive analysis on the clinical manifestation, imaging examination and postoperative pathology.3.The first choice of treatment of PCN was benign resection, According to the results of pancreatic cystic tumor size, growth area,the relationship with the surrounding tissue, intraoperative rapid pathology decided on the specific surgical procedure, to preserve normal pancreatic tissue as soon as possible.4.postoperative pancreatic fistula is the most common and most serious postoperative complications, especially with the highest incidence of pancreatic resection of interruption.benign postoperative 5 year survival rate was 100%, PCN survival rate of patients with malignant prognosis after radical resection was very low.