Original researchEvaluation of a selective management strategy of patients with primary cystic neoplasms of the pancreas

BackgroundRecent studies have shown that a selective group of patients with primary cystic neoplasms of the pancreas can be managed conservatively by radiological follow-up. The aim of this study was to analyze if such a strategy is efficient and safe.Patients and methodsA retrospective analyses was performed of patients who underwent resection between January 1992 and January 2006 for primary cystic neoplasms of the pancreas in an era of aggressive management (i.e. all patients underwent resection) in order to analyze if the selective algorithm as proposed by the Memorial Sloan-Kettering Cancer Center is efficient and safe.ResultsOne hundred patients underwent a resection for pancreatic cysts. Thirty-five percent of the patients with symptomatic cysts had a (pre)malignant lesion compared with 15% of the patients with an incidental cysts. In hospital mortality occurred in 1% of the patients and a postoperative complications in 39%. The Memorial Sloan-Kettering Cancer Center nomogram was able to correctly identify all patients with a benign incidental cyst.ConclusionA selective management strategy can be implemented and algorithm proposed by the Memorial Sloan-Kettering Cancer Center nomogram is safe and efficient.

► Selective group of patients with primary cystic neoplasms of the pancreas can be managed conservatively. ► A new algorithm proposed by the Memorial Sloan-Kettering Cancer Center helps select these patients. ► We evaluated the algorithm by including patients who underwent resection for primary cystic neoplasms of the pancreas. ► The Memorial Sloan-Kettering Cancer Center nomogram was able to correctly identify all patients with a benign incidental cyst.