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Brief review Diagnosis and management of pancreatic cystic lesion Myoung Hwan Kim Department of Internal Medicine, Division of Gastroenterology
pancreatic cystic lesion ,[object Object],[object Object],[object Object],[object Object],Incidental pseudocyst 77/F Serous cystadenoma 77/M Mucinous cystadenoma 38/F
1. Pancratic psedocyst ,[object Object],[object Object],[object Object],3wks after conservative Tx More 3weeks    PCD 2 month later
1. Pancratic psedocyst ,[object Object],[object Object],[object Object],[object Object]
1. Pancratic psedocyst ,[object Object],[object Object],[object Object],[object Object],[object Object]
1. Pancratic psedocyst ,[object Object],[object Object],[object Object],[object Object],[object Object]
1. Pancratic psedocyst ,[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of pancratic psedocyst in acute pancreatitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of pancratic psedocyst in chronic pancreatitis ,[object Object],[object Object],[object Object],[object Object]
ERCP–based algorithm for management of pancreatic pseudocysts
2. Pancratic cystic neoplasm ,[object Object],[object Object],[object Object],Mucinous cystadenoma 67/F Branch duct IPMN  Serous cystadenoma 77/M
 
Differential diagnosis  pseudocyst vs cystic neoplasm
Diagnosis of cystic neoplasm (1) <  Brugge WR et al. N Engl J Med 2004;351:1218-26>
Diagnosis of cystic neoplasm (2) <  Brugge WR et al. N Engl J Med 2004;351:1218-26>
<  Scheiman JM. Gastroenterology 2005;128:463-9   >
Diagnosis of cystic neoplasm (3) <  Brugge WR et al. N Engl J Med 2004;351:1218-26> ,[object Object],[object Object]
Algorithmic approach for the management of  cystic pancreatic lesions based on  the morphologic features of the lesion < Sahani DV et al. Radiographics 2005;25:1471-84>
Algorithmic approach for the management of  cystic pancreatic lesions based on  the morphologic features of the lesion < Sahani DV et al. Radiographics 2005;25:1471-84>
Mucinous Cystic Neoplasm Misdiagnosed as a Pseudocyst ,[object Object],[object Object],[object Object],[object Object]
Approach to  Incidental pancreatic cyst < Castillo CF et al. Arch Surg 2003;138(4):427-3>
Approach to  Incidental pancreatic cyst < Castillo CF et al. Arch Surg 2003;138(4):427-3>
management approach for pancreatic cystic lesion. <  Scheiman JM. Gastroenterology 2005;128:463-9   >
Summary Patient with pancreatic cystic lesion Associated with acute or chronic pancreatitis ? Pseudocyst Non-pseudocyst IPMN or mucinous cystadenoma Size>5cm, symptom (+) surgery Wait & See Yes No Yes No Yes No unilocular microcyst /c solid macrocyst Wait & See Yes Serous cystadenoma Cyst aspiraton (PC, ERCP) or surgery Size>2cm, Symptom (+), yonge age Yes

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Diagnosis And Management Of Pancreatic Cystic Lesion

  • 1. Brief review Diagnosis and management of pancreatic cystic lesion Myoung Hwan Kim Department of Internal Medicine, Division of Gastroenterology
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. ERCP–based algorithm for management of pancreatic pseudocysts
  • 11.
  • 12.  
  • 13. Differential diagnosis pseudocyst vs cystic neoplasm
  • 14. Diagnosis of cystic neoplasm (1) < Brugge WR et al. N Engl J Med 2004;351:1218-26>
  • 15. Diagnosis of cystic neoplasm (2) < Brugge WR et al. N Engl J Med 2004;351:1218-26>
  • 16. < Scheiman JM. Gastroenterology 2005;128:463-9 >
  • 17.
  • 18. Algorithmic approach for the management of cystic pancreatic lesions based on the morphologic features of the lesion < Sahani DV et al. Radiographics 2005;25:1471-84>
  • 19. Algorithmic approach for the management of cystic pancreatic lesions based on the morphologic features of the lesion < Sahani DV et al. Radiographics 2005;25:1471-84>
  • 20.
  • 21. Approach to Incidental pancreatic cyst < Castillo CF et al. Arch Surg 2003;138(4):427-3>
  • 22. Approach to Incidental pancreatic cyst < Castillo CF et al. Arch Surg 2003;138(4):427-3>
  • 23. management approach for pancreatic cystic lesion. < Scheiman JM. Gastroenterology 2005;128:463-9 >
  • 24. Summary Patient with pancreatic cystic lesion Associated with acute or chronic pancreatitis ? Pseudocyst Non-pseudocyst IPMN or mucinous cystadenoma Size>5cm, symptom (+) surgery Wait & See Yes No Yes No Yes No unilocular microcyst /c solid macrocyst Wait & See Yes Serous cystadenoma Cyst aspiraton (PC, ERCP) or surgery Size>2cm, Symptom (+), yonge age Yes