Introduction Back ground Distinguishing benign from malignant or pre-malignant pancreatic cystic lesions is essential when formulating the surgical therapeutic strategy. Lack of a well-defined pre-operative predictability criteria makes therapeutic planning challenging.
Aims To study the correlation between pre-operative morphological and biochemical features of resected pancreatic cystic lesions and predictive power of these features in relation to biological behaviour and final histology.
Methods We systematically reviewed the literature to identify the relevant variables that are used to predict the nature of pancreatic cystic lesions and aid therapeutic planning; this was followed by designing a template encompassing all these variables to collate data of resected pancreatic cystic lesions from two centres. We collated clinico-pathological and biochemical data, pre-operative CT, MRI, EUS, PET CT, FNA analysis and final post-operative pathology reports.
Results 63 patients with pancreatic cystic lesions were identified; 3 were drained endoscopically out of which two were psuedocyst and 1 was abscess,12 underwent resection, 3 were serous, 1 mucinous, 1 IPMN, 4 ductal adenocarcinomas, 1 endocrine neoplasm, 1 psuedocyst with abscess, one patient’s final histology results was missing. Three patients had neoplastic cells on FNAC, 2 patients had FNAC results suspicious for neoplasm, 26 were reported to have benign findings at EUS and FNAC and managed conservatively. 10 had elevated intra-cystic CEA levels, 3 patients had elevated CA 19–9 levels at FNAC. 1 patient was diagnosed having VHL, 1 patient had lymphatic cyst, 1 patient was diagnosed having Giardiasis, 1 patient was stented for palliation, 7 patients were undergoing further definitive treatment, and 1 patient with IPMN had therapeutic ERCP.
Conclusion Our interim results suggest that quadruple assessment including clinical, radiological
(CT/PET/MRI/EUS), FNAC and biochemical analysis is necessary prior to therapeutic planning.
Disclosure of Interest None Declared.
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