Serrablo-Requejo, A. (Alejandro)

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    Pancreatic mucinous cystic neoplasms located in the distal pancreas: a multicenter study
    (2022) Serradilla-Martín, M. (Mario); del-Rio-Martín, J. ( Juan); Hernández-Rivera, P.J. (Pedro J.); Muñoz-Forner, E. (Elena); Rotellar, F. (Fernando); Pardo-Sanchez, F. (Fernando); Latorre, R. (Raquel); Blanco-Fernández, G. (Gerardo); Serrablo-Requejo, A. (Alejandro); Kälviäinen-Mejia, H.K. (Helga K.); Garcés-Albir, M. (Marina); Carabias, A. (Alberto); Esteban-Gordillo, S. (Sara); Jaén-Torrejimeno, I. (Isabel); Manuel-Vazquez, A. (Alba); Ramia, J.M. (Jose M.); De-Armas-Conde, N. (Noelia); Longoria-Dubocq, T. (Texell); Cantalejo-Diaz, M. (Miguel); Sabater, L. (Luis)
    Background: 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. Methods: Retrospective multicenter observational study of prospectively recorded data regarding distal pancreatectomies was carried out at seven HPB Units between 01/01/08 and 31/12/18 (the ERPANDIS Project). Results: 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 vs. 63 years). Invasive tumors were larger (6 vs. 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. Conclusions: 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.