A selective approach to resection of cystic lesions of the pancreas: results from 539 consecutive patients.

摘要

I would like to congratulate Dr. Allen and colleagues for this very fine paper on what is probably the largest series to date addressing cystic lesions of the pancreas (CLP).1 The authors concluded that adopting a selective approach was appropriate in the management of CLP -based on the results of their study, and this could be done by using preoperative characteristics such as cyst size, presence of solid components, presence of symptoms, and age of patients. They came to this conclusion as their data demonstrated that these characteristics were significantly different in patients who underwent immediate surgery compared with those who were initially managed conservatively and that the proportion of malignant cysts in those managed conservatively was only 3% compared with those who underwent immediate surgery (18%). However, I do not agree entirely with their conclusion.