摘要随首影像学技术手段的广泛应用,胰腺囊性肿瘤的检出率显著增加,主要包括浆液性囊性肿瘤、黏液性囊性肿瘤、导管内乳头状黏液性肿瘤、实性假乳头状瘤及囊性神经内分泌肿瘤.由于不同类型之间、同一类型的不同亚型之间恶性潜能不同,胰腺囊性肿瘤的外科治疗策略亦有较大差异,关键问题是如何辨识出具有恶性潜能的肿瘤,积极行手术治疗;同时对恶变风险极低的良性肿瘤密切随访,避免不必要的手术创伤.在微创理念指导下,提倡对有切除指征的囊性肿瘤行包括单纯切除、保留十二指肠的胰头切除、胰腺中段切除、保留脾脏的胰体尾切除等术式.外科医师应严格掌握随访观察与外科切除的指征,既要避免治疗不足,更要避免治疗过度.

abstractsPancreatic cystic neoplasm(PCN) are common and increasingly detected in recent years including serous cystic neoplasms,mucinous cystic neoplasms,intraductal papillary mucinous neoplasms,solid pseudopapillary neoplasms and cystic pancreatic neuroendocrine tumors.Some of PCN have a low risk of malignancy while others have a high risk and need interventions,even in the same type of cystic neoplasms.The management of PCN requires risk stratification for malignant potential,and clinicians should have a systematic approach for establishing a diagnosis and determining which patients require surgical treatment.Under the guidance of minimally invasive surgery,some organ preserving procedures including tumor enucleation,segmental pancreatic resection,duodenum-preserving total or subtotal pancreatic head resection,and spleen-preserving pancreatic body and tail resection are recommended for treatment of PCN.The indications for follow-up or surgical intervention for treatment of PCN patients should be mastered strictly to avoid either insufficient-or over-treatment.