Diagnosis And Treatment Of Pancreatic Cystic Disease

Background: With the development of imaging diagnostic techniques, thedetection rate of pancreatic cystic disease has increased significantly over the past.Pancreatic cystic diseases including a variety of lesions. clinical diagnosis is difficult,easily lead to misdiagnosis, wrong treatment, so diagnosis and treatment of pancreaticcystic disease brought to our attention.Objective：Discuss the effective diagnostic methods and appropriate surgicaltreatment of pancreatic cystic disease.Methods：Collect67cases clinical data of pancreatic cystic disease for analysis,these cases of hospitalized patients from2001-2011.Comparative analysis for differenttypes of cystic disease of the age, sex, clinical presentation, past medical history,laboratory examinations, tumor location and other clinical data. Use software SPSS18.0to process data. Count data were compared using X2test and exact test, measurementdata were use t-test, P <0.05was considered statistically significant difference.Result：The patients average age of pseudo cyst and mucinous tumor group was55years old, solid pseudo papillary tumor patients average age was25years old.89percentpseudo cyst patients with history of pancreatitis，5percent cystic tumor patients withhistory of pancreatitis, two cases of true cysts patients with no history of pancreatitis.Pseudo cyst group have37male patients and7females. Cystic tumors group have2males,19females.Cystic disease patients with non-specific clinical symptoms and signs,25patients were found on physical examination.34of67patients with surgically treated,2cases of true cyst，8cases of mucinous tumors，1case of mucinous carcinoma,3cases ofserous tumors,7cases of solid-pseudo papillary tumor，13cases of pseudo cyst.Nopostoperative pancreatic leakage.10patients of pseudo cyst using Cyst jejunumRoux-en-Yanastomosis,1patients of pseudo cyst using cyst-stomach wallanastomosis,1patients of pseudo cyst using cyst excision,1case with external drainage;19cases cystictumors patients treated by surgery,7cases with mucinous cystadenoma,4cases using pancreatic body and tail-spleen resection,3cases using pancreatic body and tail resection;1cases with mucinous adenocarcinoma, using pancreatic oduodenectomy.3cases withserous cyst adenoma,2cases using cyst adenomare section,1cases using pancreaticphase cut-body and tail-jejunum Yanastomosis,1case with intraductal papillarymucinous tumor,using pancreaticoduodenectomy;7cases with solid pseudo papillarytumor,4cases using local tumor resection,2cases using pancreatic body andtailresection,1case using pancreatic phase cut, body and tail jejunum Yanas tomosis; Twocases of true cysts using cystectomy.Conclusion：1. Pseudo cyst is the most cystic disease of the pancreas, cystic tumor followed by,true cyst least.2.Pseudo cyst patients are predominantly male, cystictumors patients arepredominantly female.3.Most patients with pseudo cyst have pancreatitis4. Pseudo cyst mostly located in the body and tail of the pancreas, pancreaticserous cyst adenoma mostly located located in the head, mucinous cyst adenoma mostlylocated the pancreatic body and tail.5. Clinical symptoms and signs in the differential diagnosis of pancreatic cysticdisease are not specific.6. In the diagnosis of pseudo cyst CT has high accuracy than ultrasound, but in thediagnosis of cystic tumors there is no clear advantage.7. Choice of surgical approach to be combined with patients in general, cyst location,size, nature, the relationship with the surrounding tissue, considering to make appropriatechoices. Most pseudo cyst patients using cyst jejunum Roux-en-Yanas tomosis. Mostcystic tumors of the pancreas body and tail using pancreatic resection, whether combinedspleen or gastric and other relate dorgans resection depending on the specific circumstances.Cystin the pancreatic head according to the specific circumstances to choose surgicalprocedure. retention cyst have the same treatment with pseudo cyst.