| Pancreatic cystic lesion-Surgery or follow-up evaluation |
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Sung-Jo Bang, Myung-Hwan Kim |
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가톨릭대학교 의과대학 1내과학교실, 2진단방사선과교실, 3병원병리과교실 |
| 췌장의 낭종성 질환-수술 혹은 경과관찰 |
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방성조, 김명환 |
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Departments of 1Internal Medicine, 2Radiology and 3Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea |
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| Abstract |
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The decision of surgical treatment for pancreatic cystic lesions may mainly depend on the malignant potential of each lesion. Surgical excision is the most optimal treatment for the mucinous cystic neoplasm due to its high malignant potential. On the other hand, intraductal papillary mucinous neoplasm (IPMN) is divided into main duct type and branch-duct type. Main duct IPMN has high risk of malignant transformation. Therefore, surgical resection has been recommended for all main duct IPMN. Branch duct IPMN has relatively low malignant potential, and usually shows slow progression. A branch duct IPMN that is asymptomatic, less than 3 cm in size and without mural nodules may be followed-up without resection. Serous cystic neoplasm is usually benign in nature. Surgical treatment for serous cystic neoplasm should be considered when definitive diagnosis being uncertain, larger than 4 cm in size, or presence of symptoms. Solid pseudopapillary neoplasm also has low malignant potential which needs surgical excision. Surgical treatment for pancreatic pseudocyst is considered in limited cases with complication, such as infection or bleeding, and which is not controlled with non-surgical treatment. Management strategy for pancreatic cystic lesions should be individualized, and the decision to resect or follow-up a lesion should be based on factors such as the presence or absence of symptoms, patient age, cyst size, grading of malignant potential, location of the lesion, and the surgical risk of the patient. (Korean J Med 78:295-300, 2010) |
| Key Words:
Pancreas; Cystic lesion; Treatment |
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