Pancreatic Cysts. Types and Treatments. IE Understanding Pancreatic Cysts Update_F1.indd 1

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1 Pancreatic Cysts Types Treatments IE Understing Pancreatic Cysts Update_F1.indd 1

2 Reduce Your Risk Cancer Pancreatic abnmal fluid-filled pockets within pancreas. If left untreated, some lead to a deadly fm cer. Depending on extent disease, people with cerous have a five-year survival rate only five to fty percent. The good news is when surgery is perfmed on a precerous cyst, five-year survival rate is nearly 100 percent. Early diagnosis removal critical when it comes to preventing cer due to. Pancreatic Cyst Symptoms Most people with do not experience any at all. In those that do, vary depending on location cyst extent disease. The most : bdominal pain Jaundice Nausea Pancreatitis Vomiting How Pancreas Wks Weight Loss The pancreas is a six to eight inch, tapered gan across back abdomen, hind stomach. It has a wider end called head, a middle part called body a tapered end called tail. The pancreas is made up two types gls. 1. The exocrine gl secretes digestive enzymes that help break down carbohydrates, fats, proteins acids in duodenum. The enzymes secreted into a netwk ducts that join main duct that runs length pancreas. The exocrine tissue also secretes a bicarbonate that neutralizes stomach acid in duodenum. 2. The endocrine gl secretes hmones into bloodstream such as insulin. This gl is responsible f regulating level glucose (sugar) in blood. IE Understing Pancreatic Cysts Update_F1.indd 2

3 How Pancreatic Cysts re Diagnosed Most initially diagnosed when a s is perfmed to evaluate such as weight loss, nausea, vomiting diseases like kidney stones. lthough most nign at diagnosis, it is imptant to determine wher y have potential to come cerous not. This may require a me though examination cyst using a technology called endoscopic ultrasound (EUS). How Endoscopic Ultrasound (EUS) Wks The EUS procedure uses a thin, flexible tu called an endoscope to deliver an ultrasound imaging device to a to examined inside your body. Your endoscopist will pass endoscope through your mouth into stomach small intestine. Ultrasound images pancreas n obtained through stomach intestinal walls. IE Understing Pancreatic Cysts Update_F1.indd 3

4 What types Pancreatic Cysts? called called end pered end epered pancreas eo pancreas liver ouodenum. liver uodenum. ch on ch on a channel a channel stive juices ed juices stive an end an liver ddsled ncreas ded liver endwith cting eancreas liver with r.cting enum. he r. liver denum. n Duct on hannel Duct channel juices e juices en liver he liver g with ng with t Tail Tail Tail ail e digestive e, digestive two,, two, endocrine endocrine igestive estive d, two, within two, may docrine t,within you ocrine t you may diagnosis. diagnosis. hin t? ou may t? in mptoms at ncreatic uted may mptoms at to agnosis. reatic to tted gnosis. t rly rly oms at to ysts? oms at ommon There 5 types : There 5 types : Pseudo Pseudo most have a histy most have(figure a histy pancreatitis elevated blood amylase levels 2). pancreatitis elevated blood amylase levelshowever, (Figure 2). majity will not require surgery; if majity wills not require surgery; however, if What Pancreatic types Pancreatic Cysts? pseudocyst is large cyst Types Cysts pseudocyst is large sby cyst decompressed at endoscopy placement stents. What types Pancreatic Cysts? There 5 typesat : by placement stents. decompressed endoscopy Pseudo There 5 types : Pseudo in people with a histy Pseudo most have a histy pancreatitis pancreatitis elevated blood amylase levels. elevated blood mostamylase levels have a(figure histy 2). Most will not require surgery. If majity will blood not require however, if pancreatitis elevated amylasesurgery; levels (Figure 2). majity will nots require surgery; however, if pseudocyst isislarge s cyst pseudocyst large pseudocyst is large s by cyst decompressed at endoscopy placement stents. cyst decompressed decompressed at endoscopy by by placement stents. implanting stents. Figure 2. Pseudocyst Figure 2. Pseudocyst F Figur In Intrad Pa Patient su such a Serous loss. lo T Serous a no mea bran no me th in women.they generally multiple have no po women.they 3).generally multiple have no madema cerousinpotential (Figure Unless y cerous potential (Figure 3). Unless y a such aspseudocyst serous cystadenomas safely if Figure Figure such2.2. aspseudocyst serous cystadenomas safely Serousmonited without need f surgery. monited without need f surgery. in women Serous Serous no me no no me. They very unlikely to in multiple havehave no no inwomen. women.they They generally generally multiple come cerous. Unless y cerous potential Unless y cerous potential(figure (Figure3).3). Unless y such serous cystadenomas suchas as serous cystadenomas safely such as serous cystadenomas safely monited without need surgery. monited safely monited without need without needff surgery. f surgery. Figur Figure 3. Serous Figure 3. Serous F Solid So Cystic Neoplasm T abdom Cystic Neoplasm me in woman tail ab tail me in woman Patients ta in pancreas (Figure 4). f mo Figure 3. Serous in in tail (Figurecystic 4). Patients turn fo Cystic Neoplasm experience painpancreas mucinous neoplasms Figure 3. Serous experience ismucinous cystic neoplasms turn into cer. pain Surgery recommended f most tointo me in woman f most Cystic Neoplasm turn cer. Surgery is recommended remove se. toin remove me in. woman They Neoplasm tailse pancreas. Cystic in tail pancreas (Figure 4). Patients me in woman into pain likely to turn experience pain mucinous cystic neoplasms ininto cer. tail Surgery pancreas (Figure Patients cer. Surgery is recommended f most4). turn is recommended f most experience pain mucinous cystic neoplasms to remove se. to remove secer..surgery is recommended f most turn into tu to remove se. dtly Figur mmon rly F ty 2). r, if Figure 4. Cystic Neoplasm Intraductal Papillary Neoplasm (IPMN) Patients with IPMN may may not experience jaundice, weight as pancreatitis, CIE Understingsuch Pancreatic Cysts Update_F1.indd 4

5 sts? y y 2). 2). if if Figure 4. Cystic Neoplasm Intraductal Neoplasm (IPMN) Figure 4. Papillary Cystic Neoplasm Patients with IPMN sometimes experience Intraductal Papillary Neoplasm (IPMN) such as Neoplasm pancreatitis, Intraductal Papillary (IPMN) Patients with IPMN may may not experience jaundice weight loss. The disease affect weight Patients IPMN may may not experience such as with pancreatitis, jaundice, such as pancreatitis, jaundice, weight main duct a branch main loss. The disease / affect main duct loss. The disease affect main duct a branch mainhas duct (Figure have duct, potential to turn5)into a branch (Figure 5) have potential to main turn into cer.duct isdetermination will cer. n endoscopic ultrasound perfmed will potential to turn into cer. determination made at EUS wher safely monited to made determine EUSwher wher safely safely monited if a at surgery will required. if a surgery will required. monited if surgery will required. Main Duct IPMN Main Duct IPMN me me ve no ve no ptoms ptoms safely safely Side Branch IPMN Side Branch IPMN Figure 5. Intraductal Papillary Neoplasm Figure 5. Intraductal Papillary Neoplasm Solid Pseudopapillary Neoplasm Solid Pseudopapillary Neoplasm r most Solid Pseudopapillary Neoplasm r most symptom is symptom is pain. They symptom pain. r most is They in body in body tail pancreas. Surgery is pain. They in body tail pancreas (Figure 6). Surgery is recommended tail pancreas 6). Surgery is recommended recommended f most to relieve pain f most as (Figure se f most as se turn into reduce cer. risk cer. turn into cer. ts ts plasms plasms most most Figure 6. Solid Pseudopapillary Neoplasm Figure 6. Solid Pseudopapillary Neoplasm CIE Understing Pancreatic Cysts Update_F1.indd 5

6 dvantages an EUS procedure include: Me accurate than a CT (computed tomography) s MRI (magnetic resonance imaging) Can identify as small as two millimeters Provides very detailed images cyst wall cyst contents Cysts biopsied using a thin needle fluid tissue analyzed f cer. dditionally, tests dered on cyst fluid to help determine if a cyst turn into a cer in future Can provide surgeons with imptant infmation about proximity to arteries veins close to pancreas that aide in planning surgeries Safer way to biopsy than biopsies perfmed under CT-s guidance surgery Depending on findings your EUS your, your doct will make a recommendation on wher cyst should observed via surveillance, treated by endoscopy surgery. What is surveillance? F that not at high risk f coming cer, your docts may recommend a period observation where cyst will evaluated periodically by an EUS, MRI CT s. will perfmed at six-month, annual biannual intervals depending on type cyst you have. IE Understing Pancreatic Cysts Update_F1.indd 6

7 What is EUS-guided cyst ablation? Docts at Center f Interventional Endoscopy (CIE) wking on an experimental treatment by which some precerous managed by injecting chemapy medications into cyst while undergoing an EUS examination. Unlike traditional chemapy that is given through your veins, medications injected into cyst do not side-effects. Be very few studies have en perfmed so far, this treatment is delivered only under a research protocol. bout Center f Interventional Endoscopy The Center f Interventional Endoscopy integrates rapeutic endoscopy with minimally invasive surgery to provide some highest quality c f with complex digestive issues. We largest EUS program in United States, third largest in wld perfm nearly 4000 EUS procedures annually. Our docts well-published have authed numr-one, st-seller textbook in field entitled Endosonography. They conduct cuttingedge, clinical trials that paving way f new innovations in treatment. voluntary, research studies fer you access to some most advanced c in wld. If you meet right requirements, you may approached by one our docts research staff to find out if you interested in participating. To schedule an appointment, call Center f Interventional Endoscopy at (407) The preceding infmation is intended only to provide general infmation does not serve as a definitive basis f diagnosis treatment in any case. It is imptant to consult with your doct about your specific condition. IE Understing Pancreatic Cysts Update_F1.indd 7

8 FLORID HOSPITL YOUR ELITE CRE NETWORK Flida Hospital is a trusted memr one merica s largest, not-f-prit healthc systems. Center f Interventional Endoscopy 601 East Rollins Street Orlo, FL (407) FHCIE.com 18-CIE IE Understing Pancreatic Cysts Update_F1.indd 8