Mohammed Cara, Duran S Patricio Xavier, Kolomar Hugh, Thirth Tanmay, Bulmash Simcha, Joshi Sharvari Vikram, Serrano Tannia Payan, Reddy Greeshma, Arpan Turimula, Thuli Deepika Palegar, Masood Areehah Zafar, Rai Manju
Orthopaedic Surgery, Sangre Grande Hospital, Sangre Grande, TTO.
Internal Medicine, Universidad de Cuenca, Cuenca, ECU.
Cureus. 2025 Jul 23;17(7):e88607. doi: 10.7759/cureus.88607. eCollection 2025 Jul.
Pancreatic masses represent a heterogeneous spectrum of neoplasms, ranging from benign lesions such as serous cystadenomas to malignant tumors such as pancreatic ductal adenocarcinoma (PDAC). Timely and accurate differentiation among these entities is essential for devising effective therapeutic strategies. Recent advancements in diagnostic modalities, surgical techniques, and perioperative care have significantly influenced the management of pancreatic masses. This narrative review synthesizes current literature and clinical practices related to the surgical management of pancreatic masses. It examines the evolution of diagnostic tools, operative approaches, perioperative management, and the integration of emerging technologies in clinical decision-making. Imaging modalities such as contrast-enhanced CT, MRI, and endoscopic ultrasound have improved the precision of diagnosis and staging. Histopathological confirmation remains the gold standard for definitive diagnosis. Surgical options, including partial and total pancreatectomy, are tailored according to tumor type and stage, with resection being the only curative treatment for PDAC. Minimally invasive approaches, such as laparoscopic and robotic-assisted surgeries, offer the benefits of reduced morbidity and faster recovery while maintaining oncological outcomes. Neoadjuvant therapy shows promise in enhancing surgical success and survival in resectable and borderline resectable tumors. Postoperative complications such as pancreatic fistulas, delayed gastric emptying, and endocrine/exocrine insufficiencies are common challenges. For non-resectable tumors, palliative options such as biliary bypass and endoscopic stenting focus on symptom relief and quality of life. The surgical management of pancreatic masses has evolved significantly, driven by advancements in diagnostics, minimally invasive techniques, and supportive perioperative care. Emerging tools such as intraoperative imaging, artificial intelligence, and precision medicine are enabling more personalized treatment plans. A multidisciplinary approach remains critical in optimizing outcomes for patients with pancreatic neoplasms.
胰腺肿物代表了一系列异质性肿瘤，从良性病变如浆液性囊腺瘤到恶性肿瘤如胰腺导管腺癌（PDAC）。及时、准确地区分这些病变对于制定有效的治疗策略至关重要。诊断方式、手术技术和围手术期护理方面的最新进展显著影响了胰腺肿物的管理。本叙述性综述综合了与胰腺肿物手术管理相关的当前文献和临床实践。它探讨了诊断工具、手术方法、围手术期管理的演变，以及新兴技术在临床决策中的整合。诸如增强CT、MRI和内镜超声等成像方式提高了诊断和分期的准确性。组织病理学确诊仍然是明确诊断的金标准。手术选择，包括部分和全胰腺切除术，根据肿瘤类型和分期进行调整，切除是PDAC唯一的治愈性治疗方法。微创方法，如腹腔镜和机器人辅助手术，在保持肿瘤学疗效的同时，具有降低发病率和更快恢复的优点。新辅助治疗在提高可切除和临界可切除肿瘤的手术成功率和生存率方面显示出前景。术后并发症如胰瘘、胃排空延迟和内分泌/外分泌功能不全是常见的挑战。对于不可切除的肿瘤，姑息性选择如胆肠吻合术和内镜支架置入术侧重于缓解症状和提高生活质量。在诊断、微创技术和支持性围手术期护理进展的推动下，胰腺肿物的手术管理有了显著发展。术中成像、人工智能和精准医学等新兴工具正在促成更个性化的治疗方案。多学科方法对于优化胰腺肿瘤患者的治疗结果仍然至关重要。
