The majority of pancreatic cystic lesions may be successfully treated with endoscopic procedures rather than surgical interventions, thus minimizing the need for post-procedure convalescence as well as cost.\n
It has been hypothesized that pancreas and other organs may suffer cysts due to congenital defects and trauma. Though rare, the prevalence of cystic pancreas diseases and cysts in adults is high; the average age of cyst formation is around 40 years. The exact cause of most cysts remains undocumented; however, it is known that these masses are a result of a failure in the normal breakdown of mucus in the pancreas. Without knowing the root cause of these cysts, clinicians have no way to predict the progression of the condition. Currently, the treatment options for patients with cystic pancreatic diseases are surgical resection and drug therapy with cystic hydatidosis and hypercalcemia treatments.
Pancreatic cysts can develop on the head of the pancreas or the body and are found in about 5% of the population. They are frequently discovered by ultrasound or CT scanning. They are usually benign and require no active intervention.
Pancreatic cyst can be cured for the selected patients with careful evaluation. The recurrence rate of 1.9% and the mortality rate of 0.5% suggested that cure is a viable option in select cases.
The signs of pancreatic cyst depend on the structure of the cyst (simple or solid structure, fluid, or both fluids in a cyst) and can be distinguished by the presence or absence of solid content in cysts and if they contain either fluid or both fluid and solid content.
Paclitaxel has been extensively investigated in combination with gemcitabine. However the combination of gemcitabine and paclitaxel did not seem to be a commonly used combination.
Those patients with pancreatic cyst receiving gemcitabine+taxol for pancreatic cancer had a longer QOL than those who received gemcitabine alone. Further studies are necessary to investigate clinical effects of gemcitabine admixture in patients with pancreatic cyst on QOL and cyst burden.
Pancreatic cysts are common and are thought to occur with a biliary type predisposition. They may also be associated with an inflammatory condition, particularly sarcoidosis. A pancreatic cyst is likely to be associated with a benign condition. Older patients with sarcoidosis are especially at risk as the cysts usually become symptomatic by the late teens or early 20s.\n\nIn 2005, American Diabetes Association published the first set of diabetes control goals for type 2 diabetes in children and adolescents. One of the six goals is to HbA1c (glycated hemoglobin) < 7.1%. This goal is achievable for about two-thirds of patients aged 10–17 years old.
Paclitaxel/gemcitabine admixture resulted in the side effect profile seen. Although the side effect profiles observed were similar to those commonly experienced with paclitaxel monotherapy, tolerability and compliance merits consideration in adjuvant chemotherapy regimens combining paclitaxel with gemcitabine or gemcitabine alone.
There are other medical possibilities for the treatment of pancreatic cyst but pancreatic cyst surgeries are not an option for the treatment of other pancreatic tumours. Thus, current medical guidelines recommend that all patients with a single pancreatic tumour treated conservatively with close follow-up should be performed as the current treatment.
Pancreatic cysts can vary significantly in severity with respect to presenting symptoms, with cysts of less than 4 cm in diameter being most likely to undergo spontaneous resolution and no intervention requiring urgent surgery. Therefore, we recommend that the initial management of a symptomatic cyst consist of simple observational monitoring for symptom progression. Further intervention such as aspiration, or medical therapy should only be taken into consideration as appropriate depending on the severity of the patient's presentation.