Surgical outcomes of resected cystic neoplasms of pancreas: Experience from a tertiary care centre in India
Digvijoy Sharma1, Nagari Bheerappa2
1Clinic of GI-HPB, Narayana Superspeciality Hospital, Guwahati, India
2Department of GI-HPB, Nizams Institute of Medical Sciences, Hyderabad, India
Abstract
Objective: Cystic neoplasms of the pancreas form a rare heterogeneous group of pancreatic tumors with variable clinical and diagnostic characteristics. Its incidence has increased in recent years due to improvements in cross-sectional imaging methods and awareness amongst surgeons.
Material and Methods: This study aimed to study the demographic, clinical, imaging, and histopathologic characteristics, incidence of malignancy and outcome of surgical resection of pancreatic cystic neoplasms. Retrospective analysis of 91 patients who underwent surgical resection for cystic neoplasm of the pancreas between 2006 to 2017 at a tertiary care institute was done.
Results: There was a female preponderance in the study with a mean age of 47.2 years. Abdominal pain (46.1%) and jaundice (23.1%) were the most common symptoms. Computed tomography and endoultrasound (EUS) were the most commonly used imaging methods in the study and demonstrated good surgical correlation. Pancreaticoduodenectomy (37.1%) was the most commonly performed procedure followed by distal pancreaticosplenectomy (31.8%). Of the lesions, 9.8% were found malignant. Solid pseudopapillary epithelial neoplasm (SPEN) (37.3%) was the most common neoplasm followed by serous (21.9%), intraductal papillary mucinous neoplasm (IPMN) (15.3%) and mucinous neoplasm (14.3%). Preoperative radiological diagnostic correlation was found to be 75-100% implying the importance of imaging in cystic neoplasms of the pancreas. Morbidity and mortality in the study group were 28.5% and 2.1%, respectively.
Conclusion: Pancreatic cystic neoplasms were mostly benign with female preponderance and presented in the younger age group with prevalence of SPEN higher than IPMN in our subcontinent. These can be reliably diagnosed on preoperative cross-sectional imaging, and surgical resection is associated with favourable outcome and acceptable morbidity.
Keywords: Pancreatic cystic neoplasms, clinico-pathological co-relation, surgical resection
Cite this article as: Sharma D, Bheerappa N. Surgical outcomes of resected cystic neoplasms of pancreas: Experience from a tertiary care centre in India. Turk J Surg 2023; 39 (2): 128-135.
This study was approved by NH Institutional Ethics Committee (Review letter no: 1911/2022, Date: 28.06.2022).
Informed Consent:
Informed consent was obtained from the son of the patients.
Externally peer-reviewed.
Concept - DS; Design - NB; Supervision - NB; Data Collection and/or Processing - DS; Analysis and/or Interpretation - DS; Literature Review - NB; Writer- DS, NB; Critical Review - DS, NB.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.