Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 14;408(1):28.
doi: 10.1007/s00423-022-02740-0.

Surgical treatment for pancreatic cystic lesions-implications from the multi-center and prospective German StuDoQ|Pancreas registry

Jonas Henn #  1 , Patricia K Wyzlic #  1 , Irene Esposito  2 , Alexander Semaan  1 , Vittorio Branchi  1 , Carsten Klinger  3 , Heinz J Buhr  3 , Ulrich F Wellner  4 , Tobias Keck  4 , Philipp Lingohr  1 , Tim R Glowka  1 , Steffen Manekeller  1 , Jörg C Kalff  1 , Hanno Matthaei  5 ; StuDoQ|Pancreas Study Group
Affiliations

Surgical treatment for pancreatic cystic lesions-implications from the multi-center and prospective German StuDoQ|Pancreas registry

Jonas Henn et al. Langenbecks Arch Surg. .

Erratum in

Abstract

Purpose: The detection of pancreatic cystic lesions (PCL) causes uncertainty for physicians and patients, and international guidelines are based on low evidence. The extent and perioperative risk of resections of PCL in Germany needs comparison with these guidelines to highlight controversies and derive recommendations.

Methods: Clinical data of 1137 patients who underwent surgery for PCL between 2014 and 2019 were retrieved from the German StuDoQ|Pancreas registry. Relevant features for preoperative evaluation and predictive factors for adverse outcomes were statistically identified.

Results: Patients with intraductal papillary mucinous neoplasms (IPMN) represented the largest PCL subgroup (N = 689; 60.6%) while other entities (mucinous cystic neoplasms (MCN), serous cystic neoplasms (SCN), neuroendocrine tumors, pseudocysts) were less frequently resected. Symptoms of pancreatitis were associated with IPMN (OR, 1.8; P = 0.012) and pseudocysts (OR, 4.78; P < 0.001), but likewise lowered the likelihood of MCN (OR, 0.49; P = 0.046) and SCN (OR, 0.15, P = 0.002). A total of 639 (57.2%) patients received endoscopic ultrasound before resection, as recommended by guidelines. Malignancy was histologically confirmed in 137 patients (12.0%), while jaundice (OR, 5.1; P < 0.001) and weight loss (OR, 2.0; P = 0.002) were independent predictors. Most resections were performed by open surgery (N = 847, 74.5%), while distal lesions were in majority treated using minimally invasive approaches (P < 0.001). Severe morbidity was 28.4% (N = 323) and 30d mortality was 2.6% (N = 29). Increased age (P = 0.004), higher BMI (P = 0.002), liver cirrhosis (P < 0.001), and esophageal varices (P = 0.002) were independent risk factors for 30d mortality.

Conclusion: With respect to unclear findings frequently present in PCL, diagnostic means recommended in guidelines should always be considered in the preoperative phase. The therapy of PCL should be decided upon in the light of patient-specific factors, and the surgical strategy needs to be adapted accordingly.

Keywords: National Registry; Pancreas; Pancreatic Cysts; Surgical Oncology.

PubMed Disclaimer

Conflict of interest statement

TK has received payments for lectures from Intuitive Surgical Inc., Sunnyvale, US. PL has, in the past, received travel support payments from Medtronic plc., Dublin, Ireland, Ethicon inc., Bridgewater, US and KARL STORZ SE & Co. KG, Tuttlingen, Germany, and is currently employed by the German Society of General and Visceral Surgery (DGAV) for audits. For the remaining authors (JH, PKW, IE, AS, VB, CK, HJB, UFW, TRG, SM, JCK, HM) none were declared.

TK has received payments for lectures from Intuitive Surgical Inc., Sunnyvale, US. PL has, in the past, received travel support payments from Medtronic plc., Dublin, Ireland, Ethicon inc., Bridgewater, USA, and KARL STORZ SE & Co. KG, Tuttlingen, Germany, and is currently employed by the German Society of General and Visceral Surgery (DGAV) for audits. For the remaining authors (JH, PKW, IE, AS, VB, CK, HJB, UFW, TRG, SM, JCK, HM) none were declared.

Similar articles

See all similar articles

References

    1. Lee KS, Sekhar A, Rofsky NM, Pedrosa I. Prevalence of incidental pancreatic cysts in the adult population on MR imaging. Am J Gastroenterol. 2010;105:2079–2084. doi: 10.1038/ajg.2010.122. - DOI - PubMed
    1. van Huijgevoort NCM, del Chiaro M, Wolfgang CL, et al. Diagnosis and management of pancreatic cystic neoplasms: current evidence and guidelines. Nat Rev Gastroenterol Hepatol. 2019;16:676–689. doi: 10.1038/s41575-019-0195-x. - DOI - PubMed
    1. Matthaei H, Schulick RD, Hruban RH, Maitra A. Cystic precursors to invasive pancreatic cancer. Nat Rev Gastroenterol Hepatol. 2011;8:141–150. doi: 10.1038/nrgastro.2011.2. - DOI - PMC - PubMed
    1. Hackert T, Fritz S, Klauss M, et al. Main-duct intraductal papillary mucinous neoplasm. Ann Surg. 2015;262:875–881. doi: 10.1097/SLA.0000000000001462. - DOI - PubMed
    1. Park JW, Jang J-Y, Kang MJ, et al. Mucinous cystic neoplasm of the pancreas: is surgical resection recommended for all surgically fit patients? Pancreatology. 2014;14:131–136. doi: 10.1016/j.pan.2013.12.006. - DOI - PubMed

MeSH terms