The Clinical Analysis Of36Cases Serous Cystic Neoplasms Of Pancreatic

Objective: To discuss the diagnosis and treatment of serous cystic neoplasms ofpancreatic.Methods: Retrospectively analysis of the clinical data of36patients with serouscystic neoplasms of pancreatic confirmed by pathology treated from January2002toDecember2012in Dalian medical university first affiliated hospital.Results: Among the36cases of serous cystic neoplasms of pancreatic,16weremale and20were female. The range of age were26~78years old，with a mean age was58.9±13.6years. Serous cystadenomas accounts for97%in all the cases, and serouscystadenocarcinoma accounts for3%.8cases(22%) was located in the head of pancreas,4cases (11%) in the neck of pancreas,9cases(25%) in the body of pancreas, and15cases(42%) in the tail of pancreas.16patients(44.4%) were asymptomatic, and wereincidentally found. Among the asymptomatic patients,10were male and6were female,with a mean age was62.9±13.9years. And2cases located in the head or neck ofpancreas,14cases in the body or tail of pancreas. the mean size of the tumors was3.12±1.95cm.20patients (55.6%) were symptomatic, such as epigastric pain or fullness,nausea, abdominal mass, weight loss, upper gastrointestinal incomplete obstruction.Among the symptomatic patients,10were female and10were male, with mean age was55.7±12.7years. And10cases located in the head or neck of pancreas,10cases in thebody or tail of pancreas. The mean size of the tumors was5.68±2.76cm. Ultrasound,CT and MRI diagnosis rate of position were89%(32/36),100%(29/29),100%(22/22)for tumors, and the rate of correctly diagnosed were0(0/36),62%(18/29) and100%(22/22) for cystadenoma. The MRI correctly diagnosed27%of22cases for SCA. Finaldiagnosis depends on pathological examination. The36patients underwent surgicaltreatment. Except1case misdiagnosed, the tumor of the rest cases were completelyresected. The common postoperative complications had pancreatic fistula and gastroparesis with the mainly rate was55.6%. Gastroparesis were associated withpancreatic fistula. There were3patients with blood transfusion and6patients withcomplications in the asymptomatic group. There were11patients with bloodtransfusion and14patients with complications in the symptomatic group.1patient’ssymptoms didn’t relieve for misdiagnosis and1patient died, the rest recovered well.Conclusion: Pancreatic serous cystic neoplasms is the most common pancreaticcystic tumor divided into SCA and SCC. SCN occurred in middle-old aged womenpredominantly. It may appear in any part of the pancreas, but the most tumors arelocated in the body and tail of pancreas. The clinical symptoms were not distinctive andlaboratory examination only provide the reference for differential diagnosis. The rate ofthe finding of pancreatic lesions through Ultrasound, CT and MRI is higher. CT andMRI have more significance in diagnosis. Intraoperative frozen section examinationmay be misdiagnosis, and the final diagnosis depends on paraffin sections examinationafter operation. We need distinguish SCN from pancreatic pseudocyst and other types ofcystic tumor. With the increase of the size of SCN, The clinical symptoms appear, thesurgical trauma and postoperative complications are increased. Surgical resection is thesafe and effective treatment for SCN. No matter the size of the tumor and clinicalsymptoms appeared in the patient, SCA need actively operative treatment unless occurin the older patients or have operation contraindication. The principle of the operation iscompletely surgical resection of the tumor, and mostly reserve the internal and externalsecretion functions of pancreas. According to the size and site of the tumor and thepatient’s general condition, individually select operation method. In the operation ofSCN, we should carefully probe pancreas and abdominal organs, and define thecharacter of the tumor by frozen section examination of multiple sites sampling, thatdecrease the rate of misdiagnosis.