Zusammenfassung
GRUNDLAGEN: Die modernen bildgebenden Verfahren haben zu einem Anstieg der Inzidenz der primär zystischen Pankreastumore geführt. Früher war die chirurgische Behandlung obligat. Nach Art und Größe des Tumors kann jedoch auch ein konservativer Ansatz befürwortet werden. METHODIK: Literaturübersicht und Darstellung eigener Erfahrungen. ERGEBNISSE: Von 43 zystischen Neoplasmen wurden 11 (33 %) zufällig entdeckt, 22 (77 %) Patienten hatten Symptome zum Zeitpunkt der Diagnose. 33 (78 %) Patienten wurden operativ, 10 (22 %) Patienten jedoch konservativ behandelt. Bei neun (27 %) Patienten wurde Malignität festgestellt. Sieben (78 %) mit malignen und 15 (63 %) mit benignen Pankreastumor hatten Symptome. Die mediane Zystengröße lag bei 3,5 cm (1,5–12). SCHLUSSFOLGERUNGEN: Die Therapie kann, nach Größe und Charakter der Pankreaszyste, adaptiert werden. Die chirurgische Behandlung allein ist nicht mehr die einzige Behandlungsmöglichkeit der primär zystischen Pankreastumore.
Summary
BACKGROUND: Owing to modern imaging techniques, the incidence of primary cystic neoplasms of the pancreas is increasing. During the past decades all pancreatic cysts were treated operatively. Depending on type and size a more conservative approach can be advocated. METHOD: Review of the literature and presentation of institutional experience. RESULTS: From 43 patients, 11 (33%) were discovered incidentally and 22 (77%) had symptoms at the time of diagnosis. 33 (78%) underwent operative treatment, whereas 10 (22%) were treated conservatively. Malignancy was found in nine (27%) operated patients. Seven patients (78%) with malignant cystic neoplasm and 15 patients (63%) with a benign cystic neoplasm had symptoms. Median cyst size was 3.5 cm (1.5–12). There was one case of malignancy within cystic lesion smaller than 3 cm. CONCLUSIONS: Therapy can be tailored depending on size and character of the pancreatic cyst. Surgical treatment alone is no longer pivotal.
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Akan, B., Sahora, K., Puhalla, H. et al. Cystic neoplasms of the pancreas: conservative or operative treatment?. Eur Surg 40, 220–226 (2008). https://doi.org/10.1007/s10353-008-0423-z
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DOI: https://doi.org/10.1007/s10353-008-0423-z