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Evaluation of solid and cystic pancreatic lesions, with emphasis on correct staging, multidisciplinary decision-making and safe surgical planning.
When to seek surgical evaluation
Jaundice, stool discoloration or dark urine
New or abrupt dysregulation of diabetes mellitus
Finding on CT, MRI or endoscopic ultrasound
Unexplained weight loss, epigastric pain with reflection in the back
What happens at the first appointment
Review of imaging and laboratory tests
Assessment of resectability and general condition
Discussion in an oncology board when necessary
Clear information about the operation, risks, recovery and possible adjuvant or neoadjuvant treatment
Goal: not to make a hasty decision. Surgery is recommended when the expected benefit outweighs the risks and when alternatives have been evaluated.
Frequently Asked Questions
Does every pancreatic cyst require surgery?
No. Most of the cysts are frequently followed up. Surgery is discussed when there are high-risk features or clear evidence of malignancy/precancerous lesions.
When is Whipple needed?
Pancreaticoduodenectomy is discussed mainly for lesions of the head of the pancreas or the periampullary region, when the disease is surgically resectable.
