Department of Internal Medicine, Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea.
Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea.
Korean J Intern Med. 2022 Jan;37(1):63-72. doi: 10.3904/kjim.2020.452. Epub 2021 Jul 29.
BACKGROUND/AIMS: The study aimed to investigate the current practice patterns in the management of pancreatic cystic neoplasms in Korea.
An electronic survey was systematically distributed by email to members of the Korean Pancreatobiliary Association from December 2019 to February 2020.
In total, 115 (110 gastroenterologists, five surgeons) completed the survey, 72.2% of whom worked in a tertiary/academic medical center. Most (65.2%) followed the 2012/2017 International Association of Pancreatology guidelines for the management of pancreatic cystic neoplasms. A gadolinium-enhanced magnetic resonance imaging/magnetic resonance cholangiopancreatography was the most common first-line diagnostic modality (42.1%), but a contrast-enhanced computed tomography scan was preferred as a subsequent surveillance tool (58.3%). Seventy-four percent of respondents routinely performed endoscopic ultrasound-guided fine needle aspiration for pancreatic cystic neoplasms with suspicious mural nodules. Endoscopic ultrasound-guided fine needle aspiration cytology (94.8%) and cystic fluid carcinoembryonic antigen (95.7%) were used for cystic fluid analysis. Most (94%) typically recommended surgery in patients with high-risk stigmata, but 18.3% also considered proceeding with surgery in patients with worrisome features. Most (96.5%) would continue surveillance of pancreatic cystic neoplasms for more than 5 years.
According to this survey, there was variability in the management of pancreatic cystic neoplasms among the respondents. These results suggest that the development of evidence-based guidelines for pancreatic cystic neoplasms that fit the Korean practice is needed to create an optimal approach to the management of pancreatic cystic neoplasms.
背景/目的：本研究旨在调查韩国胰腺囊性肿瘤管理的当前实践模式。
2019 年 12 月至 2020 年 2 月，通过电子邮件向韩国胰腺胆道协会成员系统地分发电子调查。
共有 115 名（110 名胃肠病学家，5 名外科医生）完成了调查，其中 72.2%的人在三级/学术医疗中心工作。大多数（65.2%）遵循 2012/2017 年国际胰腺病学会胰腺囊性肿瘤管理指南。钆增强磁共振成像/磁共振胰胆管成像（MRI/MRCP）是最常见的一线诊断方式（42.1%），但增强 CT 扫描是首选的后续监测工具（58.3%）。74%的受访者常规对有可疑壁结节的胰腺囊性肿瘤进行超声内镜引导下细针抽吸。94.8%的人进行超声内镜引导下细针抽吸细胞学检查（EUS-FNA），95.7%的人进行囊液癌胚抗原（CEA）检测。大多数（94%）通常建议高危标志物患者进行手术，但 18.3%的人也认为有可疑特征的患者也可以进行手术。大多数（96.5%）将继续对胰腺囊性肿瘤进行超过 5 年的监测。
根据这项调查，受访者对胰腺囊性肿瘤的管理存在差异。这些结果表明，需要制定符合韩国实践的胰腺囊性肿瘤循证指南，以制定胰腺囊性肿瘤管理的最佳方法。
