Objective The objective was to determine whether surgical enucleation
of mucinous cystadenoma of the pancreas is a safe and adequate operati
on. Summary Background Data Mucinous cystadenomas of the pancreas are
premalignant cystic lesions. Resection is the preferred treatment but
often requires a pancreatoduodenectomy or a distal pancreatectomy with
or without a splenectomy. Although these procedures can now be perfor
med with a low mortality rate, substantial morbidity still occurs, esp
ecially in patients who have an otherwise normal pancreas. Methods Bet
ween January 1990 and June 1997, 36 mucinous cystadenomas of the pancr
eas were resected at The Johns Hopkins Hospital. Most of these patient
s underwent pancreatoduodenectomy or distal pancreatectomy. However, 1
0 patients (28%) underwent enucleation of their cystic tumor. These 10
patients had a mean age of 63 years, and 6 were men. The cystic lesio
n was demonstrated by computed tomography in all patients. Enucleation
of the cyst was performed in each patient, and four underwent another
concomitant abdominal procedure. These 10 patients were followed with
periodic computed tomographic scans and clinical examinations. Result
s Enucleation took less time and was associated with less blood loss t
han resection. Pancreatic fistulas occurred more frequently after enuc
leation, but the incidence of major complications was similar between
the two groups. Follow-up after enucleation averaged 43 months, and no
ne of the patients developed late sequelae or recurrence. Conclusions
This experience suggests that enucleation of mucinous cystadenomas of
the pancreas can be performed safely and that the recurrence rate is l
ow after this procedure. The authors conclude that enucleation is an a
dequate procedure for benign cystic neoplasms of the pancreas.