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Erschienen in: Journal of Gastrointestinal Surgery 4/2013

01.04.2013 | Evidence-Based Current Surgical Practice

Cystic Neoplasms of the Pancreas

verfasst von: Anne Marie Lennon, Christopher Wolfgang

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 4/2013

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Abstract

Pancreatic cysts are being identified with increasing frequency due to a combination of increased awareness and more frequent use of cross sectional imaging. Cystic neoplasms of the pancreas range from completely benign to frankly malignant. Identifying pre-malignant cysts offers the opportunity to prevent the development of pancreatic cancer. This article reviews the presentation, workup, and non-operative and operative management of premalignant and malignant pancreatic cysts.
Literatur
1.
Zurück zum Zitat Ikeda M, Sato T, Morozumi A, Fujino MA, Yoda Y, Ochiai M, et al. Morphologic changes in the pancreas detected by screening ultrasonography in a mass survey, with special reference to main duct dilatation, cyst formation, and calcification. Pancreas. 1994;9(4):508–12. Epub 1994/07/01.PubMedCrossRef Ikeda M, Sato T, Morozumi A, Fujino MA, Yoda Y, Ochiai M, et al. Morphologic changes in the pancreas detected by screening ultrasonography in a mass survey, with special reference to main duct dilatation, cyst formation, and calcification. Pancreas. 1994;9(4):508–12. Epub 1994/07/01.PubMedCrossRef
2.
Zurück zum Zitat Laffan TA, Horton KM, Klein AP, Berlanstein B, Siegelman SS, Kawamoto S, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR American journal of roentgenology. 2008;191(3):802–7. Epub 2008/08/22.PubMedCrossRef Laffan TA, Horton KM, Klein AP, Berlanstein B, Siegelman SS, Kawamoto S, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR American journal of roentgenology. 2008;191(3):802–7. Epub 2008/08/22.PubMedCrossRef
3.
Zurück zum Zitat de Jong K, Nio CY, Hermans JJ, Dijkgraaf MG, Gouma DJ, van Eijck CH, et al. High prevalence of pancreatic cysts detected by screening magnetic resonance imaging examinations. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2010;8(9):806–11. Epub 2010/07/14.CrossRef de Jong K, Nio CY, Hermans JJ, Dijkgraaf MG, Gouma DJ, van Eijck CH, et al. High prevalence of pancreatic cysts detected by screening magnetic resonance imaging examinations. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2010;8(9):806–11. Epub 2010/07/14.CrossRef
4.
Zurück zum Zitat Lee KS, Sekhar A, Rofsky NM, Pedrosa I. Prevalence of incidental pancreatic cysts in the adult population on MR imaging. The American journal of gastroenterology. 2010;105(9):2079–84. Epub 2010/04/01.PubMedCrossRef Lee KS, Sekhar A, Rofsky NM, Pedrosa I. Prevalence of incidental pancreatic cysts in the adult population on MR imaging. The American journal of gastroenterology. 2010;105(9):2079–84. Epub 2010/04/01.PubMedCrossRef
5.
Zurück zum Zitat Valsangkar N, Morales-Oyarvide V, Thayer S, Ferrone C, Wargo J, Warshaw A, et al. 851 resected cystic tumors of the pancreas: A 33-year experience at the Massachusetts General Hospital. Surgery. 2012;Epub ahead of print. Valsangkar N, Morales-Oyarvide V, Thayer S, Ferrone C, Wargo J, Warshaw A, et al. 851 resected cystic tumors of the pancreas: A 33-year experience at the Massachusetts General Hospital. Surgery. 2012;Epub ahead of print.
6.
Zurück zum Zitat Tanaka M, Fernandez-Del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012;12(3):183–97. Epub 2012/06/13.PubMed Tanaka M, Fernandez-Del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012;12(3):183–97. Epub 2012/06/13.PubMed
7.
Zurück zum Zitat Reddy RP, Smyrk TC, Zapiach M, Levy MJ, Pearson RK, Clain JE, et al. Pancreatic mucinous cystic neoplasm defined by ovarian stroma: demographics, clinical features, and prevalence of cancer. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2004;2(11):1026–31. Epub 2004/11/20.CrossRef Reddy RP, Smyrk TC, Zapiach M, Levy MJ, Pearson RK, Clain JE, et al. Pancreatic mucinous cystic neoplasm defined by ovarian stroma: demographics, clinical features, and prevalence of cancer. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2004;2(11):1026–31. Epub 2004/11/20.CrossRef
8.
Zurück zum Zitat Kimura W, Moriya T, Hanada K, Abe H, Yanagisawa A, Fukushima N, et al. Multicenter study of serous cystic neoplasm of the Japan pancreas society. Pancreas. 2012;41(3):380–7. Epub 2012/03/15.PubMedCrossRef Kimura W, Moriya T, Hanada K, Abe H, Yanagisawa A, Fukushima N, et al. Multicenter study of serous cystic neoplasm of the Japan pancreas society. Pancreas. 2012;41(3):380–7. Epub 2012/03/15.PubMedCrossRef
9.
Zurück zum Zitat Crippa S, Salvia R, Warshaw AL, Dominguez I, Bassi C, Falconi M, et al. Mucinous cystic neoplasm of the pancreas is not an aggressive entity: lessons from 163 resected patients. Annals of surgery. 2008;247(4):571–9. Epub 2008/03/26.PubMedCrossRef Crippa S, Salvia R, Warshaw AL, Dominguez I, Bassi C, Falconi M, et al. Mucinous cystic neoplasm of the pancreas is not an aggressive entity: lessons from 163 resected patients. Annals of surgery. 2008;247(4):571–9. Epub 2008/03/26.PubMedCrossRef
10.
Zurück zum Zitat Yamao K, Yanagisawa A, Takahashi K, Kimura W, Doi R, Fukushima N, et al. Clinicopathological features and prognosis of mucinous cystic neoplasm with ovarian-type stroma: a multi-institutional study of the Japan pancreas society. Pancreas. 2011;40(1):67–71. Epub 2010/10/07.PubMedCrossRef Yamao K, Yanagisawa A, Takahashi K, Kimura W, Doi R, Fukushima N, et al. Clinicopathological features and prognosis of mucinous cystic neoplasm with ovarian-type stroma: a multi-institutional study of the Japan pancreas society. Pancreas. 2011;40(1):67–71. Epub 2010/10/07.PubMedCrossRef
11.
Zurück zum Zitat Khashab MA, Shin EJ, Amateau S, Canto MI, Hruban RH, Fishman EK, et al. Tumor size and location correlate with behavior of pancreatic serous cystic neoplasms. The American journal of gastroenterology. 2011;106(8):1521–6. Epub 2011/04/07.PubMedCrossRef Khashab MA, Shin EJ, Amateau S, Canto MI, Hruban RH, Fishman EK, et al. Tumor size and location correlate with behavior of pancreatic serous cystic neoplasms. The American journal of gastroenterology. 2011;106(8):1521–6. Epub 2011/04/07.PubMedCrossRef
12.
Zurück zum Zitat Reddy S, Cameron JL, Scudiere J, Hruban RH, Fishman EK, Ahuja N, et al. Surgical management of solid-pseudopapillary neoplasms of the pancreas (Franz or Hamoudi tumors): a large single-institutional series. Journal of the American College of Surgeons. 2009;208(5):950–7; discussion 7–9. Epub 2009/05/30.PubMedCrossRef Reddy S, Cameron JL, Scudiere J, Hruban RH, Fishman EK, Ahuja N, et al. Surgical management of solid-pseudopapillary neoplasms of the pancreas (Franz or Hamoudi tumors): a large single-institutional series. Journal of the American College of Surgeons. 2009;208(5):950–7; discussion 7–9. Epub 2009/05/30.PubMedCrossRef
13.
Zurück zum Zitat Yang F, Fu DL, Jin C, Long J, Yu XJ, Xu J, et al. Clinical experiences of solid pseudopapillary tumors of the pancreas in China. Journal of gastroenterology and hepatology. 2008;23(12):1847–51. Epub 2008/08/30.PubMedCrossRef Yang F, Fu DL, Jin C, Long J, Yu XJ, Xu J, et al. Clinical experiences of solid pseudopapillary tumors of the pancreas in China. Journal of gastroenterology and hepatology. 2008;23(12):1847–51. Epub 2008/08/30.PubMedCrossRef
14.
Zurück zum Zitat Papavramidis T, Papavramidis S. Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English literature. Journal of the American College of Surgeons. 2005;200(6):965–72. Epub 2005/06/01.PubMedCrossRef Papavramidis T, Papavramidis S. Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English literature. Journal of the American College of Surgeons. 2005;200(6):965–72. Epub 2005/06/01.PubMedCrossRef
15.
Zurück zum Zitat Malleo G, Bassi C, Rossini R, Manfredi R, Butturini G, Massignani M, et al. Growth pattern of serous cystic neoplasms of the pancreas: observational study with long-term magnetic resonance surveillance and recommendations for treatment. Gut. 2012;61(5):746–51. Epub 2011/09/24.PubMedCrossRef Malleo G, Bassi C, Rossini R, Manfredi R, Butturini G, Massignani M, et al. Growth pattern of serous cystic neoplasms of the pancreas: observational study with long-term magnetic resonance surveillance and recommendations for treatment. Gut. 2012;61(5):746–51. Epub 2011/09/24.PubMedCrossRef
16.
Zurück zum Zitat Sahani DV, Kadavigere R, Saokar A, Fernandez-del Castillo C, Brugge WR, Hahn PF. Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics: a review publication of the Radiological Society of North America, Inc. 2005;25(6):1471–84. Epub 2005/11/15.CrossRef Sahani DV, Kadavigere R, Saokar A, Fernandez-del Castillo C, Brugge WR, Hahn PF. Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics: a review publication of the Radiological Society of North America, Inc. 2005;25(6):1471–84. Epub 2005/11/15.CrossRef
17.
Zurück zum Zitat Brugge WR, Lewandrowski K, Lee-Lewandrowski E, Centeno BA, Szydlo T, Regan S, et al. Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study. Gastroenterology. 2004;126(5):1330–6. Epub 2004/05/08.PubMedCrossRef Brugge WR, Lewandrowski K, Lee-Lewandrowski E, Centeno BA, Szydlo T, Regan S, et al. Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study. Gastroenterology. 2004;126(5):1330–6. Epub 2004/05/08.PubMedCrossRef
18.
Zurück zum Zitat van der Waaij LA, van Dullemen HM, Porte RJ. Cyst fluid analysis in the differential diagnosis of pancreatic cystic lesions: a pooled analysis. Gastrointestinal endoscopy. 2005;62(3):383–9. Epub 2005/08/23.PubMedCrossRef van der Waaij LA, van Dullemen HM, Porte RJ. Cyst fluid analysis in the differential diagnosis of pancreatic cystic lesions: a pooled analysis. Gastrointestinal endoscopy. 2005;62(3):383–9. Epub 2005/08/23.PubMedCrossRef
19.
Zurück zum Zitat Frossard JL, Amouyal P, Amouyal G, Palazzo L, Amaris J, Soldan M, et al. Performance of endosonography-guided fine needle aspiration and biopsy in the diagnosis of pancreatic cystic lesions. The American journal of gastroenterology. 2003;98(7):1516–24. Epub 2003/07/23.PubMedCrossRef Frossard JL, Amouyal P, Amouyal G, Palazzo L, Amaris J, Soldan M, et al. Performance of endosonography-guided fine needle aspiration and biopsy in the diagnosis of pancreatic cystic lesions. The American journal of gastroenterology. 2003;98(7):1516–24. Epub 2003/07/23.PubMedCrossRef
20.
Zurück zum Zitat Galanis C, Zamani A, Cameron JL, Campbell KA, Lillemoe KD, Caparrelli D, et al. Resected serous cystic neoplasms of the pancreas: a review of 158 patients with recommendations for treatment. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract. 2007;11(7):820–6. Epub 2007/04/19.CrossRef Galanis C, Zamani A, Cameron JL, Campbell KA, Lillemoe KD, Caparrelli D, et al. Resected serous cystic neoplasms of the pancreas: a review of 158 patients with recommendations for treatment. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract. 2007;11(7):820–6. Epub 2007/04/19.CrossRef
21.
Zurück zum Zitat Tseng JF, Warshaw AL, Sahani DV, Lauwers GY, Rattner DW, Fernandez-del Castillo C. Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Annals of surgery. 2005;242(3):413–9; discussion 9–21. Epub 2005/09/02.PubMed Tseng JF, Warshaw AL, Sahani DV, Lauwers GY, Rattner DW, Fernandez-del Castillo C. Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Annals of surgery. 2005;242(3):413–9; discussion 9–21. Epub 2005/09/02.PubMed
22.
Zurück zum Zitat Khalid A, Brugge W. ACG practice guidelines for the diagnosis and management of neoplastic pancreatic cysts. The American journal of gastroenterology. 2007;102(10):2339–49. Epub 2007/09/04.PubMedCrossRef Khalid A, Brugge W. ACG practice guidelines for the diagnosis and management of neoplastic pancreatic cysts. The American journal of gastroenterology. 2007;102(10):2339–49. Epub 2007/09/04.PubMedCrossRef
23.
Zurück zum Zitat Kimura W, Makuuchi M. Operative indications for cystic lesions of the pancreas with malignant potential—our experience. Hepato-gastroenterology. 1999;46(25):483–91. Epub 1999/05/06.PubMed Kimura W, Makuuchi M. Operative indications for cystic lesions of the pancreas with malignant potential—our experience. Hepato-gastroenterology. 1999;46(25):483–91. Epub 1999/05/06.PubMed
24.
Zurück zum Zitat Kang MJ, Jang JY, Kim SJ, Lee KB, Ryu JK, Kim YT, et al. Cyst growth rate predicts malignancy in patients with branch duct intraductal papillary mucinous neoplasms. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2011;9(1):87–93. Epub 2010/09/21.CrossRef Kang MJ, Jang JY, Kim SJ, Lee KB, Ryu JK, Kim YT, et al. Cyst growth rate predicts malignancy in patients with branch duct intraductal papillary mucinous neoplasms. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2011;9(1):87–93. Epub 2010/09/21.CrossRef
25.
Zurück zum Zitat Levy P, Jouannaud V, O’Toole D, Couvelard A, Vullierme MP, Palazzo L, et al. Natural history of intraductal papillary mucinous tumors of the pancreas: actuarial risk of malignancy. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2006;4(4):460–8. Epub 2006/04/18.CrossRef Levy P, Jouannaud V, O’Toole D, Couvelard A, Vullierme MP, Palazzo L, et al. Natural history of intraductal papillary mucinous tumors of the pancreas: actuarial risk of malignancy. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2006;4(4):460–8. Epub 2006/04/18.CrossRef
26.
Zurück zum Zitat Kosmahl M, Pauser U, Peters K, Sipos B, Luttges J, Kremer B, et al. Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal. Virchows Archiv: an international journal of pathology. 2004;445(2):168–78. Epub 2004/06/09. Kosmahl M, Pauser U, Peters K, Sipos B, Luttges J, Kremer B, et al. Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal. Virchows Archiv: an international journal of pathology. 2004;445(2):168–78. Epub 2004/06/09.
27.
Zurück zum Zitat Warshaw AL, Compton CC, Lewandrowski K, Cardenosa G, Mueller PR. Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Annals of surgery. 1990;212(4):432–43; discussion 44–5. Epub 1990/10/01.PubMedCrossRef Warshaw AL, Compton CC, Lewandrowski K, Cardenosa G, Mueller PR. Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Annals of surgery. 1990;212(4):432–43; discussion 44–5. Epub 1990/10/01.PubMedCrossRef
28.
Zurück zum Zitat Le Borgne J, de Calan L, Partensky C. Cystadenomas and cystadenocarcinomas of the pancreas: a multiinstitutional retrospective study of 398 cases. French Surgical Association. Annals of surgery. 1999;230(2):152–61. Epub 1999/08/18.PubMedCrossRef Le Borgne J, de Calan L, Partensky C. Cystadenomas and cystadenocarcinomas of the pancreas: a multiinstitutional retrospective study of 398 cases. French Surgical Association. Annals of surgery. 1999;230(2):152–61. Epub 1999/08/18.PubMedCrossRef
29.
Zurück zum Zitat Sarr MG, Carpenter HA, Prabhakar LP, Orchard TF, Hughes S, van Heerden JA, et al. Clinical and pathologic correlation of 84 mucinous cystic neoplasms of the pancreas: can one reliably differentiate benign from malignant (or premalignant) neoplasms? Annals of surgery. 2000;231(2):205–12. Epub 2000/02/16.PubMedCrossRef Sarr MG, Carpenter HA, Prabhakar LP, Orchard TF, Hughes S, van Heerden JA, et al. Clinical and pathologic correlation of 84 mucinous cystic neoplasms of the pancreas: can one reliably differentiate benign from malignant (or premalignant) neoplasms? Annals of surgery. 2000;231(2):205–12. Epub 2000/02/16.PubMedCrossRef
30.
Zurück zum Zitat Thompson LD, Becker RC, Przygodzki RM, Adair CF, Heffess CS. Mucinous cystic neoplasm (mucinous cystadenocarcinoma of low-grade malignant potential) of the pancreas: a clinicopathologic study of 130 cases. The American journal of surgical pathology. 1999;23(1):1–16. Epub 1999/01/15.PubMedCrossRef Thompson LD, Becker RC, Przygodzki RM, Adair CF, Heffess CS. Mucinous cystic neoplasm (mucinous cystadenocarcinoma of low-grade malignant potential) of the pancreas: a clinicopathologic study of 130 cases. The American journal of surgical pathology. 1999;23(1):1–16. Epub 1999/01/15.PubMedCrossRef
31.
Zurück zum Zitat Horisawa M, Niinomi N, Sato T, Yokoi S, Oda K, Ichikawa M, et al. Frantz’s tumor (solid and cystic tumor of the pancreas) with liver metastasis: successful treatment and long-term follow-up. Journal of pediatric surgery. 1995;30(5):724–6. Epub 1995/05/01.PubMedCrossRef Horisawa M, Niinomi N, Sato T, Yokoi S, Oda K, Ichikawa M, et al. Frantz’s tumor (solid and cystic tumor of the pancreas) with liver metastasis: successful treatment and long-term follow-up. Journal of pediatric surgery. 1995;30(5):724–6. Epub 1995/05/01.PubMedCrossRef
32.
Zurück zum Zitat Allen PJ, D'Angelica M, Gonen M, Jaques DP, Coit DG, Jarnagin WR, et al. A selective approach to the resection of cystic lesions of the pancreas: results from 539 consecutive patients. Annals of surgery. 2006;244(4):572–82. Epub 2006/09/26.PubMed Allen PJ, D'Angelica M, Gonen M, Jaques DP, Coit DG, Jarnagin WR, et al. A selective approach to the resection of cystic lesions of the pancreas: results from 539 consecutive patients. Annals of surgery. 2006;244(4):572–82. Epub 2006/09/26.PubMed
33.
Zurück zum Zitat Goh BK, Tan YM, Cheow PC, Chung YF, Chow PK, Wong WK, et al. Cystic lesions of the pancreas: an appraisal of an aggressive resectional policy adopted at a single institution during 15 years. American journal of surgery. 2006;192(2):148–54. Epub 2006/07/25.PubMedCrossRef Goh BK, Tan YM, Cheow PC, Chung YF, Chow PK, Wong WK, et al. Cystic lesions of the pancreas: an appraisal of an aggressive resectional policy adopted at a single institution during 15 years. American journal of surgery. 2006;192(2):148–54. Epub 2006/07/25.PubMedCrossRef
34.
Zurück zum Zitat Gan SI, Thompson CC, Lauwers GY, Bounds BC, Brugge WR. Ethanol lavage of pancreatic cystic lesions: initial pilot study. Gastrointestinal endoscopy. 2005;61(6):746–52. Epub 2005/04/28.PubMedCrossRef Gan SI, Thompson CC, Lauwers GY, Bounds BC, Brugge WR. Ethanol lavage of pancreatic cystic lesions: initial pilot study. Gastrointestinal endoscopy. 2005;61(6):746–52. Epub 2005/04/28.PubMedCrossRef
35.
Zurück zum Zitat Oh HC, Seo DW, Lee TY, Kim JY, Lee SS, Lee SK, et al. New treatment for cystic tumors of the pancreas: EUS-guided ethanol lavage with paclitaxel injection. Gastrointestinal endoscopy. 2008;67(4):636–42. Epub 2008/02/12.PubMedCrossRef Oh HC, Seo DW, Lee TY, Kim JY, Lee SS, Lee SK, et al. New treatment for cystic tumors of the pancreas: EUS-guided ethanol lavage with paclitaxel injection. Gastrointestinal endoscopy. 2008;67(4):636–42. Epub 2008/02/12.PubMedCrossRef
36.
Zurück zum Zitat Oh HC, Seo DW, Kim SC, Yu E, Kim K, Moon SH, et al. Septated cystic tumors of the pancreas: is it possible to treat them by endoscopic ultrasonography-guided intervention? Scandinavian journal of gastroenterology. 2009;44(2):242–7. Epub 2008/10/25.PubMedCrossRef Oh HC, Seo DW, Kim SC, Yu E, Kim K, Moon SH, et al. Septated cystic tumors of the pancreas: is it possible to treat them by endoscopic ultrasonography-guided intervention? Scandinavian journal of gastroenterology. 2009;44(2):242–7. Epub 2008/10/25.PubMedCrossRef
37.
Zurück zum Zitat DeWitt J, McGreevy K, Schmidt CM, Brugge WR. EUS-guided ethanol versus saline solution lavage for pancreatic cysts: a randomized, double-blind study. Gastrointestinal endoscopy. 2009;70(4):710–23. Epub 2009/07/07.PubMedCrossRef DeWitt J, McGreevy K, Schmidt CM, Brugge WR. EUS-guided ethanol versus saline solution lavage for pancreatic cysts: a randomized, double-blind study. Gastrointestinal endoscopy. 2009;70(4):710–23. Epub 2009/07/07.PubMedCrossRef
38.
Zurück zum Zitat Oh HC, Seo DW, Song TJ, Moon SH, Park do H, Soo Lee S, et al. Endoscopic ultrasonography-guided ethanol lavage with paclitaxel injection treats patients with pancreatic cysts. Gastroenterology. 2011;140(1):172–9. Epub 2010/10/19.PubMedCrossRef Oh HC, Seo DW, Song TJ, Moon SH, Park do H, Soo Lee S, et al. Endoscopic ultrasonography-guided ethanol lavage with paclitaxel injection treats patients with pancreatic cysts. Gastroenterology. 2011;140(1):172–9. Epub 2010/10/19.PubMedCrossRef
39.
Zurück zum Zitat DiMaio CJ, DeWitt JM, Brugge WR. Ablation of pancreatic cystic lesions: the use of multiple endoscopic ultrasound-guided ethanol lavage sessions. Pancreas. 2011; 40(5):664–8. Epub 2011/05/13.PubMedCrossRef DiMaio CJ, DeWitt JM, Brugge WR. Ablation of pancreatic cystic lesions: the use of multiple endoscopic ultrasound-guided ethanol lavage sessions. Pancreas. 2011; 40(5):664–8. Epub 2011/05/13.PubMedCrossRef
Metadaten
Titel
Cystic Neoplasms of the Pancreas
verfasst von
Anne Marie Lennon
Christopher Wolfgang
Publikationsdatum
01.04.2013
Verlag
Springer-Verlag
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 4/2013
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-012-2072-6

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