Ramia Jose M, Del Rio Martín Juan, Blanco-Fernández Gerardo, Cantalejo-Diaz Miguel, Pardo Fernando, Muñoz-Forner Elena, Carabias Alberto, Manuel-Vazquez Alba, Hernández-Rivera Pedro J, Jaén-Torrejimeno Isabel, Kälviäinen-Mejia Helga K, Rotellar-Sastre Fernando, Garcés-Albir Marina, Latorre Raquel, Longoria-Dubocq Texell, De Armas-Conde Noelia, Serrablo-Requejo Alejandro, Esteban Gordillo Sara, Sabater Luis, Serradilla-Martín Mario
Department of Surgery, Hospital General Universitario de Alicante, ISABIAL: Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Spain.
Universidad Miguel Hernandez Alicante, Alicante, Spain.
Gland Surg. 2022 May;11(5):795-804. doi: 10.21037/gs-21-703.
Mucinous cysts of the pancreas (MCN) are infrequent, usually unilocular tumors which occur in postmenopausal women and are located in the pancreatic body/tail. The risk of malignancy is low. The objective is to define preoperative risk factors of malignancy in pancreatic MCN and to assess the feasibility of the laparoscopic approach.
Retrospective multicenter observational study of prospectively recorded data regarding distal pancreatectomies was carried out at seven hepatopancreatobiliary (HPB) Units between 01/01/08 and 31/12/18 (the ERPANDIS Project).
Four hundred and forty-four distal pancreatectomies were recorded including 47 MCN (10.6%). Thirty-five were non-invasive tumors (74.5%). In all, 93% of patients were female, and 60% were ASA (American Society of Anaesthesiology) II. The mean preoperative size was 46 mm. Patients with invasive tumors were older (54 63 years). Invasive tumors were larger (6 4 cm), although the difference was not significant (P=0.287). Sixty percent was operated via laparoscopic approach, which was used in 74.6% of non-invasive tumors and in 16.7% of the invasive ones. The spleen was not preserved in 93.6% of the patients. R0 resection was obtained in all patients. Two patients with invasive tumors died.
In our surgical series of MCN, patients with malignancy were older and presented larger tumors, although the difference was not statistically significant. Laparoscopy is a safe and feasible approach for MCN. Prospective studies are now needed to define risk factors that can guide the decision whether to administer conservative treatment or to operate.
胰腺黏液性囊肿（MCN）较为少见，通常为单房性肿瘤，好发于绝经后女性，位于胰体/尾部。恶性风险较低。目的是明确胰腺MCN的术前恶性风险因素，并评估腹腔镜手术方法的可行性。
在7个肝胆胰（HPB）科室对2008年1月1日至2018年12月31日期间前瞻性记录的有关远端胰腺切除术的数据进行回顾性多中心观察研究（ERPANDIS项目）。
共记录444例远端胰腺切除术，其中47例为MCN（10.6%）。35例为非侵袭性肿瘤（74.5%）。总体而言，93%的患者为女性，60%为美国麻醉医师协会（ASA）Ⅱ级。术前平均大小为46mm。侵袭性肿瘤患者年龄较大（54±63岁）。侵袭性肿瘤更大（6±4cm），尽管差异无统计学意义（P=0.287）。60%通过腹腔镜手术，非侵袭性肿瘤的腹腔镜手术使用率为74.6%，侵袭性肿瘤为16.7%。93.6%的患者未保留脾脏。所有患者均实现R0切除。2例侵袭性肿瘤患者死亡。
在我们的MCN手术系列中，恶性肿瘤患者年龄较大且肿瘤较大，尽管差异无统计学意义。腹腔镜手术对MCN是一种安全可行的方法。现在需要进行前瞻性研究以确定可指导决定是否进行保守治疗或手术的风险因素。
