Studies of diagnostic imaging and surgical treatment on patients with pancreatic cysts

A retrospective study of 36 cases of pancreatic cyst treated during the recent 13 years was performed from the aspects of imaging and treatment. Visualization of the internal structure by abdominal echography and CT was rare in inflammatory cysts, but frequent in neoplastic cysts. Differentiation between mucous and serous cystadenoma on the basis of properties was possible. Retrograde pancreatography, which disclosed the entire pancreatic ductal system, was important in determining surgical procedure. Angiography was effective for differentiating between benign and malignant cysts, even though some of the inflammatory cysts suggested malignant findings. The most frequent therapy in cases of inflammatory cyst was internal fistulization, with additional side-to-side pancreaticojejunostomy as a procedure for underlying chronic pancreatitis. Neoplastic cysts were resected in all cases, and the procedure for pancreatic cancer was modified for use in the cases of cystic adenocarcinoma. The remote postoperative results in the cases of inflammatory cyst were satisfactory: symptomatic improvement was found in 83.1 % of patients and occupational rehabilitation in 70.6 %. All of the three patients with cystic adenocarcinoma are well, including the one surviving a maximum period of 4 years and 10 months. (author)