Pancreatic cystic formations: selection of treatment tactics

Abstract

Introduction. The prevalence of pancreatic cystic formations is about 10%, and in the group of patients over 70 years of age, the incidence of pancreatic cysts increases to 30%. Diagnosis and surgical treatment of this pathology remains one of the most difficult problems of modern surgery and oncology. The aim: to improve the results of treatment of patients with pancreatic cystic formations by optimizing the choice of surgical and conservative treatment methods. Material and methods. Analysis of treatment results of 81 patients with pancreatic cysts is presented. Among the patients, there were 39 (48.1%) women and 42 (51.9%) men aged 18 to 64. The average age of the patients was 48.9±1.9 years. The criteria for exclusion from the study were verified solid pancreatic formations (cancer, pseudotumor pancreatitis, neuroendocrine tumors), parasitic cysts, congenital polycystic pancreas. Cysts associated with chronic pancreatitis occurred in 59 (72.8%) patients, in the outcome of acute pancreatitis – 13 (16.1 %) and in 9 (11.1 %) patients’ treatment was carried out for cystic tumors. Results of conservative, minimally invasive (puncture) and surgical methods of treatment are compared. Results. It was shown that long term results of surgical treatment were the best, however, the number of complications in this group of patients was maximum. The effectiveness of puncture treatment depended directly on the connection of cyst with Wirsung duct. Finally, results of conservative treatment were the least favorable. Conclusion. According to the study results, algorithm of pancreatic cystic formations treatment based on etiology of the disease, cyst connection with the ductal system of pancreas and the size of formation.