Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy,
Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
Dig Surg. 2020;37(1):1-9. doi: 10.1159/000496509. Epub 2019 Jan 11.
The prevalence of undefined pancreatic cystic neoplasms (PCNs) is high in the general population, increasing with patient age. PCNs account for different biological entities with different potential for malignant transformation. The clinician must balance his or her practice between the risk of surgical overtreatment and the error of keeping a malignant lesion under surveillance.
We review and discuss the clinical management of PCNs. Specifically, we analyze the main features of PCNs from the surgeon's point of view, as they present in the outpatient clinic. We also review the different consensus guidelines, address recent controversies in the literature, and present the current clinical practice at 4 different European Centers for pancreatic surgery.
The main features of PCNs were analyzed from the surgeon's point of view as they present in the outpatient clinic. All aspects of surgical management were discussed, from indications for surgery to intraoperative management and surveillance strategies.
Management of PCNs requires a selective approach with the aim of minimizing clinically relevant diagnostic mistakes. Through the evaluation of clinical and radiological features of a PCN, the surgeon can elaborate on a diagnostic hypothesis and assess malignancy risk, but the final decision should be tailored to the individual patient's need.
在普通人群中，未定义的胰腺囊性肿瘤（PCN）的患病率很高，并且随着患者年龄的增长而增加。PCN 代表不同的生物学实体，具有不同的恶性转化潜力。临床医生必须在手术过度治疗的风险和对恶性病变进行监测的错误之间取得平衡。
我们回顾和讨论了 PCN 的临床管理。具体来说，我们从外科医生的角度分析了 PCN 的主要特征，因为它们出现在门诊中。我们还回顾了不同的共识指南，讨论了文献中的最新争议，并介绍了 4 个不同的欧洲胰腺外科中心的当前临床实践。
从外科医生在门诊中遇到的角度分析了 PCN 的主要特征。讨论了手术管理的各个方面，包括手术适应证、术中管理和监测策略。
PCN 的管理需要采用有选择性的方法，旨在最大程度地减少临床相关的诊断错误。通过评估 PCN 的临床和影像学特征，外科医生可以对诊断假设进行阐述，并评估恶性风险，但最终决策应根据患者的个体需求进行调整。
