Cystic neoplasms of the pancreas: conservative or operative treatment?Zystische Tumore des Pankreas: Konservative oder chirurgische Therapie?

BACKGROUND: Owing to modern imaging techniques, the incidence of primary cystic neoplasms of the pancreas is increasing. During the past decades all pancreatic cysts were treated operatively. Depending on type and size a more conservative approach can be advocated. METHOD: Review of the literature and presentation of institutional experience. RESULTS: From 43 patients, 11 (33%) were discovered incidentally and 22 (77%) had symptoms at the time of diagnosis. 33 (78%) underwent operative treatment, whereas 10 (22%) were treated conservatively. Malignancy was found in nine (27%) operated patients. Seven patients (78%) with malignant cystic neoplasm and 15 patients (63%) with a benign cystic neoplasm had symptoms. Median cyst size was 3.5 cm (1.5–12). There was one case of malignancy within cystic lesion smaller than 3 cm. CONCLUSIONS: Therapy can be tailored depending on size and character of the pancreatic cyst. Surgical treatment alone is no longer pivotal.