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Serous cyst adenoma of the pancreas: appraisal of active surgical strategy before it causes problems

Authors
 Ho Kyoung Hwang  ;  Hyunki Kim  ;  Chang Moo Kang  ;  Woo Jung Lee 
Citation
 Surgical Endoscopy , Vol.26(6) : 1560-1565, 2012 
Journal Title
 Surgical Endoscopy  
ISSN
 0930-2794 
Issue Date
2012
Abstract
BACKGROUND: Patients who are diagnosed with symptomatic or ambiguous serous cyst adenoma (SCA) need surgery. The purpose of this study is to suggest a potential management plan based on analysis of surgically treated SCAs. METHODS: Between August 1995 and December 2010, 38 patients with SCA were surgically treated. Data were analyzed retrospectively. RESULTS: Among 38 patients, 28 were female and ten were male. Mean age was 49.6 ± 14.1 years, and five patients (13.2%) were older than 65 years. Among the five patients, two were more than 70 years old. Seventeen patients (44.7%) were symptomatic, and the rest (21, 55.3%) were incidentally found to have SCA. Twenty-seven patients underwent open pancreatectomy, and 11 patients received laparoscopic distal pancreatectomy. Mean tumor size was 4.4 ± 2.8 cm. Most asymptomatic patients of SCA had a left-sided pancreatic tumor and distal pancreatectomy with or without splenectomy were frequently performed with short operative time and less blood transfusion (P < 0.05). Minimally invasive surgery was mostly applied to left-sided tumors less than 5 cm in size (11/19 vs. 0/6, P = 0.029). Combined resection of the right colon was performed in two patients (5.3%) due to severe adhesion associated with large tumors. Significant association was noted between age and tumor size in asymptomatic patients (correlation coefficient = 0.541, R (2) = 0.293, P = 0.014). Postoperative pancreatic fistula was observed in five patients (13.2%, grade B) but could be managed conservatively. No mortality was found. CONCLUSION: Before SCA causes symptoms or grows larger than 5 cm, an active surgical approach, such as minimally invasive surgery, needs to be considered.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91907
DOI
10.1007/s00464-011-2070-x
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
Yonsei Authors
강창무(Kang, Chang Moo) ; 김현기(Kim, Hyunki) ; 이우정(Lee, Woo Jung) ; 황호경(Hwang, Ho Kyoung)
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