Surgical Treatment of Pancreatic Serous Cystadenoma - Aggressive for Operations but Limited Resections

Objective: Serous cystadenomas of the pancreas are being increasingly identified as the advancement of the diagnostic abdominal imaging. However , the optimal timing of surgical intervention for this disease remains controversial. Methods : A total of 44 patients presenting with serous cystadenoma of the pancreas from 1981 to 2006 were identified. The patients were divided into 3 groups, nonoperated, operated without correct preoperative diagnosis, and operated with correct preoperative diagnosis. The tumor characteristics, preoperative symptoms, operative procedures, morbidity, mortality, tumor recurrences, and postoperative life quality are compared. Results: Nine patients did not receive operation because of high surgical risks or no presenting symptoms. Fourteen patients received operation under correct preoperative diagnosis, and 21 patients received operation under incorrect preoperative diagnosis. In the group with correct preoperative diagnosis, the average tumor size was 5 .4 cm, 5 patients had preoperative symptoms, and 4 patients received limited resection. In the group without correct preoperative diagnosis, the average tumor size was 4 cm, 11 patients had preoperative symptoms, and 3 patients underwent limited resection. All patients are satisfied with the quality of life postoperatively. No patients have tumor recurrences during follow-ups. Conclusions: Unless the diagnosis of serous cystadenoma is certain, all cystic tumors should be resected if operative risks are acceptable. The procedures should be as limited as possible if no evidence of malignancy is noted preoperatively