What Are The Types Of Pancreatic Cysts & How Do You Remove A Pancreatic Cyst?

The pancreas is a large organ behind the stomach that produces hormones and enzymes that help digest food(1).

Pancreatic cysts are typically found during imaging testing for another problem(1).

What Are The Types Of Pancreatic Cysts?

There are four types of pancreatic cysts that have been labeled according to the nomenclature. The first one and the most common one is Pancreatic pseudocyst. It comprises a pseudo or false sac formation in the vicinity of the pancreas or sometimes it can be found at some different site. It commonly occurs in response to acute pancreatitis resulting from gallstone or alcohol intoxication. There is a rupture of the pancreatic duct leading to leakage of pancreatic enzymes and other contents into the surrounding area. This leakage is contained in the nearby zone with the help of fibrous tissue forming a layer around the content. Since it is not a true epithelial tissue that is why it is known as a pseudocyst.

The second type of pancreatic cyst is serous cystadenoma. These are usually benign cyst with a size of less than 2 cm in most cases and are mostly asymptomatic but if they increase in size than they may cause various symptoms. These are filled with clear fluid that is why known as serous cystadenoma(2).

The third type of pancreatic cyst is a connecting link between cancerous and benign lesions and are precancerous, these are known as intraductal papillary mucinous neoplasm (IPMNs). These are small cysts growing within the ducts of the pancreas and can be connected to the intestine for pouring their contents which are highly proteinaceous mucinous materials.

The last but not the least type of pancreatic cyst is cancerous mucinous cystic neoplasms. These are malignant and produce very thick highly proteinaceous mucin. This can grow very large and also metastasize to other tissues.it has a very poor prognosis is compared to all the three other cystic lesions of the pancreas.

How Do You Remove A Pancreatic Cyst?

Since most of the cystic lesions of the pancreas are benign, there is no immediate need for cure and surgical removal for them. Serous cystadenoma is benign and does not turn into a cancerous lesion and can be left without any treatment as long as they do not bothersome for the patient. In cases of the pseudocyst, if the patient is symptomatic then the drainage can be done of the contents with the help of a radiological marking to relieve the symptoms of the patient and prevent it from growing(3).

If there is an intraductal papillary mucinous neoplasm of mucinous cystadenocarcinoma then there is an urgent requirement of the removal of the cancerous cyst because it cannot get corrected by itself and will spread with time. Surgical removal is done in most of the cases for the cystic tissue as well as surrounding potentially cancerous tissue. Various surgical approaches have been devised to make the removal easier because pancreatic surgery is a very difficult surgery to perform. Whipple’s operation is done to remove widespread pancreatic tissue and distal pancreatectomy is preferred when there is the involvement of the pancreatic tail only(4).

Conclusion

Although, after widespread research, it has been concluded that there can be more than 20 types of cystic lesions of the pancreas but according to most classifications this has been categorized into four major types of cystic lesions as told above.

Usually, most of the pancreatic cysts are small in size and benign in nature but sometimes few cysts also. There is no requirement of surgery in benign and asymptomatic lesions but surgery is compulsory with a widespread tissue removal in cancerous cystic lesions even when they are asymptomatic.

References:

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