Published online Apr 21, 2021. doi: 10.3748/wjg.v27.i15.1630
Peer-review started: December 21, 2020
First decision: January 10, 2021
Revised: January 24, 2021
Accepted: March 22, 2021
Article in press: March 22, 2021
Published online: April 21, 2021
Processing time: 113 Days and 21.3 Hours
Pancreatic cystic neoplasms may present recurrent acute pancreatitis (RAP). Little is known on the role of resection for preventing RAP and if any correlation of higher prevalence of malignancy is seen among these patients.
Predicting malignancy among the pancreatic cystic neoplasms and management of RAP is challenging.
The objective of this research was to study the role of resection to help prevent RAP and analyze if presentation as RAP would be a predictor for malignancy.
We adopted a retrospective cohort study model, enrolling all the patients with pancreatic cystic neoplasms who underwent surgical resection and compare between those who presented with RAP and without RAP. Incidence of RAP after resection and prevalence of malignancy among those who presented with RAP were the primary outcomes.
Malignancy was similar among those with vs without RAP for all patients 20.7% vs 16.8%. The mean episodes of acute pancreatitis before vs after surgery were 3.4 vs 0.02 (P < 0.0001). These findings clearly contribute much to this area of science. Although, this study clearly shows the risk reduction of RAP after the pancreatic resection, further investigation with large population prospective study is needed to prove a causal relationship between the cause of RAP and pancreatic resection.
When patients with RAP are noted to have pancreatic cysts, it should be emphasized to differentiate if those cysts are the cause or the effect of RAP, i.e., if cystic neoplasms are causing the RAP or if cysts are pseudocysts as a result of RAP. Larger data is needed to see if there exists a causal relationship. Similar to the presentation of jaundice as a predictor for malignancy among pancreas cystic neoplasms, RAP may have a role as a predictor of high-risk cysts.
Future research to be focused on a larger prospective cohort to answer the above two questions.