Pancreatic Cysts (cont.)
What is the treatment for pancreatic cysts?
The most important aspect of management of pancreatic cysts is the
determination of whether a cyst is benign (and usually needs no treatment) or if
it is cancerous and must be removed.
The second most important aspect of management is to determine whether a
patient with a precancerous or cancerous pancreatic cyst is a suitable surgical
candidate. In medical centers experienced in performing pancreas surgery,
surgical removal of precancerous or cancerous cysts has a high rate of cure.
There are not yet standard recommendations for managing pancreatic cysts.
Different medical centers have adopted different approaches to diagnosis and
treatment. Management decisions must be individualized for each patient after
discussions with a doctor familiar with the patient's health status. The
following is one example of how a doctor may manage pancreatic cysts.
- Pancreatic pseudocysts need treatment if they persist beyond six weeks
after acute pancreatitis, especially if they reach a large enough size and cause
symptoms such as obstruction of the stomach or common duct, abdominal pain, or
become infected.
- Small pancreatic cysts (for example, cysts smaller than two cm) will have
little chance (3.5%) of being cancerous and can be observed. Nevertheless, even
these small cysts can grown in size and turn cancerous in the future. Thus,
these patients are monitored with yearly scans (for example, yearly CT scans).
These patients will be evaluated further using endoscopic ultrasound with possible
fine needle aspiration if the
cysts grow in size and/or cause symptoms.
- Pancreatic cysts larger than two cm in young, healthy individuals usually
are treated with surgical removal, especially if the cysts produce symptoms.
- Pancreatic cysts larger than two cm in elderly patients can be studied
with endoscopic ultrasound and fine needle aspiration. If fluid cytology and CEA measurements suggest cancerous or
precancerous changes, the patients can be evaluated for pancreatic surgery.
Last Editorial Review: 4/13/2007
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