Management of 100 consecutive cases of XXXX : wait for symptoms and see at imaging or vice versa?

@entity1 @entity5115 @entity548 @entity5 @entity75 @entity158 @entity12679
@entity12679 have a @entity5 rate. When nonsymptomatic, in selected @entity1 , they can be managed without surgery; however, a high degree of diagnostic reliability is crucial. We admitted 100 consecutive cases (87 @entity1 with a median age of 51.86 years). Of these, 44 were symptomatic and 56 were diagnosed incidentally. Ultrasound correctly diagnosed 53% of the cases, incorrectly 31%, and was nondiagnostic in 16%. Computed tomography scan had similar rates (54%, 34% and 12%, respectively), while magnetic resonance imaging improved diagnostic accuracy to 74% and reduced incorrect diagnoses to 26%. In 21 cases, exploratory needle aspiration of the cyst was carried out; only 8 samples (38%) resulted in a diagnosis; in 12 @entity1 (57%) insufficient material was acquired to allow for diagnosis, one case demonstrated @entity5115 . In 1 @entity1 an exploratory puncture resulted in a very serious @entity548 . Sixty-eight @entity1 were treated surgically, the 44 symptomatic cases and another 24 @entity1 with ill-defined @entity75 that could not be differentiated as serous or mucinous in the preoperative period. Two @entity1 underwent resection because of @entity5 growth. In the two time periods analyzed (the first 7 years and the subsequent 6.5 years) the relationship between cases observed/operated on did not significantly change. Twenty-one (30.8%) distal pancreatectomies, 14 (20.5%) intermediate resections, 10 (14.7%) pancreaticoduodenectomies 4 (5.8%) enucleations, and 1 (1.4%) duodenum-preserving pancreatic head resection were carried out. Nine @entity1 (13.2%), underwent exploratory laparotomy with a diagnostic biopsy. Another 9 underwent decompressive interventions with cystojejunostomies. The morbidity was 27.9%, with a reoperation rate of 7.3% and zero mortality. In general the @entity1 's @entity158 resolved in the postoperative period. Median follow-up was 43 months (range, 4-191 months). One @entity1 died from other causes, and all others are currently alive. In the group of 32 @entity1 who did not undergo operation, the median follow-up is 69 months (range, 8-164 months). Until more sophisticated technologies can be developed, the current diagnostic work-up will not result in increased preoperative diagnosis of serous-cystic @entity5 of the pancreas. This is mainly relevant to the oligocystic forms, which account for about one fourth of all serous @entity5 observed.
