Related Experiment Video
Updated: May 21, 2025
Laparoscopic Duodenum-Preserving Pancreatic Head Resection via Inferior Infracolic Approach: A Surgical Approach for Benign Lesions
Published on: February 9, 2024
Natural History of Pancreatic Cyst with Diameter as Solitary Risk Factor
Ankur P Choubey1, Remo Alessandris1, Misha T Armstrong1
1From the Departments of Surgery (Choubey, Alessandris, Armstrong, D'Angelica, Jarnagin, Wei, Soares), Memorial Sloan Kettering Cancer Center, New York, NY.
Background:
Multiple pancreatic cyst surveillance guidelines include cyst diameter 3 cm or greater as a worrisome feature prompting surgical referral.
Study Design:
This was a single-center retrospective review of patients with pancreatic cysts 3 cm or greater at diagnosis and no other worrisome features. Cyst progression was defined as the development of additional worrisome features, pancreatic cancer diagnosis, or pancreatectomy. Pseudocysts and biopsy-proven malignancies or non-intraductal papillary mucinous neoplasm cysts at initial consultation were excluded.
Results:
Between 2010 and 2019, 89 patients met eligibility criteria with median age of 70.9 (21 to 91) years, cyst size of 3.5 (3.10 to 9.7) cm, and follow-up of 85.7 (30.8 to 139.3) months. Cyst progression or resection occurred in 13 during follow-up There were no cases of pancreatic cancer or high-grade dysplasia on postoperative pathology. Twelve patients (13%) died without evidence of progression. Cumulative incidence of progression from surveillance initiation was 3.4% (95% CI 0.9% to 8.8%) at 3 months, 5.6% (95% CI 2.1% to 11.9%) at 9 months, 9.0% (95% CI 4.2% to 16.2%) at 15 months, 11.2% (95% CI 5.7% to 18.8%) at 21 months, and 13.7% (95% CI 7.5% to 21.8%) at 57 months.
Conclusions:
Pancreatic cysts with a diameter 3 cm or greater as the sole worrisome feature can be safely monitored with low rates of progression during surveillance, and no incidence of cancer or high-grade dysplasia in our cohort.
Related Concept Videos
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include: