Operative Resection is Currently Overutilized for Cystic Lesions of the Pancreas

Excerpt

If I trip and fall on the sidewalk today, and present to the local Emergency Department, I will likely receive a high-quality, contrast enhanced, CT scan of my abdomen (probably with 3-D reconstruction!). This scan, obtained for other reasons, will have a 2.5–5.0 % chance of showing a cystic lesion in my pancreas.1 Dr. Schmidt will propose today, regardless of the features of this cyst, that I should undergo a pancreatectomy to have it removed. As more and more patients are identified with very small, asymptomatic cysts, we feel that routine resection is no longer justified and that a large group of patients can be identified in which the risk of malignancy is less than the risk of mortality from operative resection (2 % in large centers). In this group of patients, radiographic surveillance is warranted. …