title: Surgical management and results for cystic neoplasms of pancreas.
abstract: OBJECTIVE
  The diagnosis for cystic neoplasm of pancreas is based on the morphologic criteria through imaging studies, but the pre- and postoperative diagnoses are often inconsistent. This study aims at the analysis of clinical characteristics and the results of surgical treatments.
  
  
  METHODS
  A retrospective review was performed on 93 patients who have undergone surgery for pancreatic cystic diseases in our hospital from January 2001 to February 2013. Among them, 69 patients were confirmed as cystic neoplasms based on pathologic findings. Their clinical manifestations, diagnostic accuracy, surgical method and complications, pathologic findings were analyzed.
  
  
  RESULTS
  Serous cystic neoplasm was the most common (n=22), followed by mucinous cystic neoplasm (n=18), intraductal papillary mucinous tumor (n=11), solid pseudopapillary tumor (n=9), neuroendocrine tumor (n=7), and cystic lymphangioma (n=2). The most common clinical symptom is abdominal pains (49.3%). Preoperative imaging studies were consistent with pathological findings in 72% of patients. Cystic fluid CEA levels of 400 ng/ml or more were reliable to detect mucin secreting tumors. Pancreatoduodenectomy was performed for 13 cases and the remaining 54 patients were treated with left-side pancreatectomy. Malignancy was found in 9 cases (13%) of mucin secreting tumors; 5 cases (27.8%) in mucinous cystic neoplasm and 4 cases (36.4%) in intraductal papillary mucinous tumor. Two of these survived without recurrences during the follow-up periods.
  
  
  CONCLUSIONS
  Exact treatment protocols for cystic neoplasm of pancreas are not decided because tumors are found with atypical forms. Surgical management is suggested for resectable tumors because a good prognosis can be expected with proper surgery if precancerous lesions are suspected at the time of discovery.
authors.affiliation: Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Han
authors.affiliation: Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Ryun
authors.initials: R
authors.lastname: Ha
authors.affiliation: Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Kun Kuk
authors.initials: KK
authors.lastname: Kim
authors.affiliation: Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Jung Nam
authors.initials: JN
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Yeon Suk
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Yang Seo
authors.initials: YS
authors.lastname: Koo
authors.affiliation: Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Yeon Ho
authors.initials: YH
authors.lastname: Park
keywords: Cystic neoplasm of pancreas; Malignancy; Surgical management