Analysis Of Clinical Diagnosis And Treat-ment Of Pancreatic Cystic Neoplasms

Objective: To discuss the clinical presentations of pancreatic cystic neoplasms,radiographic examination and treatments.Methods: Retrospective analysis of the clinical data from2009January to2013October in234cases of pancreatic cystic neoplasms patients, were treated inthe department of hepatobiliary surgery of the PLA General Hospital. Summarizeand analyze the clinical presentations, imaging features, diagnosis, treatment.Results: Research data234cases of patients were divided into four groups ac-cording to disease. SCNs group of43patients, of which7were males and36females, the ratio is1:5.1between men and women, age9-77years, mean (47.04±14.08) years of age.40patients underwent surgery, the patient was dischargedafter three cases observed. MCNs group of69cases of patients, male25cases,female44cases, the ratio between men and women was1:1.76, age21-82years,mean (47.74±14.64) years of age.67patients underwent surgery, one case ofabandon treatment, one case of hospital observation. IPMNs group of9patients,7males and2females, the ratio of1:0.29between men and women, age36-72years, mean (51.67±11.97) years old, underwent surgery. SPNs group113pa-tients, male20cases, female93cases, the ratio between men and women was1:4.65, age10-56years, mean (29.46±11.77) years of age.Most of patients hadnon-specific clinical presentations. Tumor diameter of0.5～23cm, average5.657±3.456cm.Most tumors in the pancreatic head and tail of the pancreas. Tu-mor type can be determined base on imaging characteristics.229cases of patientsunderwent surgery.Postoperative complications occurred in64cases,1cases ofdeath, pancreatic fistula was the main complication. The pathology after surgery:186cases of benign tumor,43cases of malignant tumor.Conclusion:1、PCNs is a rare pancreatic exocrine tumors, mainly in women.2、 The appearance of clinical symptoms associated with tumor size (P=0.0181), lo-cation of the tumor (P=0.0462), disease type (P=0.001).3、Tumor sizeassociated with tumor location (p=0.0003), disease type (p=0.001).4、Benignand malignant conditions was not associate with the patient’s symptoms (p=0.1769), the age (p=0.2345), tumor size (p=0.2894).5、PCNs patients had noobvious clinical symptoms, and no specific tumor markers, diagnosis relies onimaging examination.6、According to the imaging characteristics, preoperativetumor determine the classification decision reasonable treatment.The patient isconsidered SCNs and BD-IPMNs with no symptoms that can conduct regular im-aging examination, if the patient has the onset of symptoms or radiographicexamination increased significantly,surgery should be considered. MCNs, SPNsand MD-IPMNs should be actively resected because of malignant potential, theextent of surgery based on the results of intraoperative frozen pathology.