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08.05.2019 | main topic | Ausgabe 3/2019 Open Access

European Surgery 3/2019

Management of cystic pancreatic lesions

European Surgery > Ausgabe 3/2019
Assoc. Prof. PD Dr. Klaus Sahora, Univ. Prof. Dr. Martin Schindl
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Three decades ago, cystic neoplasia of the pancreas were a relatively unknown and poorly classified tumor entity. Nowadays, they account for a large proportion of treated lesions in the field of pancreatic surgery. Depending on the cyst type and morphology, a conservative and observational treatment approach has become standard in selected cases. Cystic tumors of the pancreas include both, neoplastic cysts with a variable malignant potential and pseudocysts, which occur as a consequence of a previous pancreatis.


Contrast-enhanced multiphase computed tomographic (CT) scan, magnetic resonance imaging (MRI) with the possibility of non-invasive cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS) are the key methods for detailed diagnostic evaluation and risk assessment of cystic pancreatic tumors.


Treatment of cystic tumors of the pancreas is safe according the published guidelines.


In patients with a confirmed diagnosis of the cyst subtype, pancreatic resection should be performed in surgically fit patients for intraductal papillary mucinous neoplasia (IPMN) with main duct and mixed type appearance, mucinous cystic neoplasia (MCN) and solid pseudopapillary neoplasia (SPN) regardless their size.

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