Enucleation of pancreatic cystadenomas

Optimal surgical treatment of pancreatic cystadenomas is controversial due to the rarity of the tumors and paucity of studies regarding long-term outcomes. This is especially true for large pancreatic cystadenomas. The objective of this study was to determine the safety and effectiveness of treating pancreatic cystadenomas by enucleation.

Eleven cases of pancreatic mucinous or serous cystadenomas were selected for enucleation according to the following criteria: (1) the benign nature of the tumors was ascertained preoperatively and intraoperatively, (2) small tumors or larger tumors no more than 6 cm in diameter growing outwardly with small tumor beds, and (3) the main pancreatic duct was not in jeopardy of damage by enucleation. The patients' demographics, tumor features, morbidity, and follow-up results were retrospectively reviewed and analyzed.

Among 11 cases, three were serous cystadenomas and eight were mucinous cystadenomas; the average size of the neoplasms was 4.8 cm (ranging from 3 to 6 cm). Two cases were complicated by the development of fistulas postoperatively and one had an incision infection. All cases were followed up from 23 to 67 months, which revealed no neoplasm recurrence or new onset of diabetes mellitus; one patient developed a pseudocyst in the body 30 months after enucleation.

It is safe and effective to perform enucleation for well-selected benign pancreatic cystadenomas even if the tumor size is as large as 6 cm, and the endocrine or exocrine function of the pancreas is maintained as much as possible.