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Suggest Treatment For Cysts In Liver, Pancreas And Gallstones

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Posted on Thu, 20 Nov 2014
Question: I just received information about my MRI.
Scary. Cysts through my pancreas.
Cysts in my liver and gall stones.
I also have pain, bloat and gas daily.

Any recommendations?
doctor
Answered by Dr. Shafi Ullah Khan (32 minutes later)
Brief Answer:
Cholecystectomy and further management

Detailed Answer:
Thank you for asking

Lets talk about them one by one.

1) Pancreatic Cyst
Pancreatic cysts are collections (pools) of fluid that can form within the head, body, and tail of the pancreas. Some pancreatic cysts are true cysts (non-inflammatory cysts), that is, they are lined by a special layer of cells that are responsible for secreting fluid into the cysts. Other cysts are pseudocysts (inflammatory cysts) and do not contain specialized lining cells.

The most important aspect of management of pancreatic cysts is the determination of whether a cyst is benign (and usually needs no treatment) or if it is precancerous or cancerous and must be removed.



The second most important aspect of management is to determine whether a patient with a precancerous or cancerous pancreatic cyst is a suitable surgical candidate. In medical centers experienced in performing pancreatic surgery, surgical removal of precancerous or cancerous cysts results in a high rate of cure.

Very small cysts can be followed to detect an increase in size that may indicate cancer or an increased risk of developing cancer. Not all cysts need to have endoscopic ultrasound or be aspirated; some may have characteristics so suggestive of malignancy that surgery is recommended without endoscopic ultrasound. Others may have characteristics so suggestive of a non-cancerous cyst that no endoscopic ultrasound needs to be done although imaging studies (ultrasound, CT, MRI) may be repeated periodically. There are not yet standard recommendations for managing pancreatic cysts. Different medical centers have adopted different approaches to diagnosis and treatment. Management decisions must be individualized for each patient after discussions with a doctor familiar with the patient's health status. The following is one example of how a doctor might manage pancreatic cysts.

Pancreatic pseudocysts need treatment if they persist beyond six weeks after acute pancreatitis, especially if they reach a large size and cause symptoms such as obstruction of the stomach or common bile duct, abdominal pain, or become infected. Small pancreatic cysts (for example, cysts smaller than one cm) will have little chance of being cancerous. Nevertheless, even these small cysts can grow in size and turn cancerous in the future. Thus, these patients are monitored with yearly scans (for example, yearly ultrasound or MRI). The cysts do not have to be evaluated with endoscopic ultrasound and fine needle aspiration. If the cysts grow in size and/or cause symptoms, the patient will be evaluated further using endoscopic ultrasound and fine needle aspiration.
Pancreatic cysts larger than 2 cm in young, healthy individuals usually are treated with surgical removal, especially if the cysts produce symptoms.
Pancreatic cysts larger than 2 cm in elderly patients can be studied with endoscopic ultrasound and fine needle aspiration. If fluid cytology, CEA measurements or analysis of DNA suggest cancerous or precancerous changes, the patients can be evaluated for pancreatic surgery.

2) Liver cysts
hepatic cyst usually refers to solitary nonparasitic cysts of the liver, also known as simple cysts. However, several other cystic lesions must be distinguished from true simple cysts. Cystic lesions of the liver include simple cysts, multiple cysts arising in the setting of polycystic liver disease (PCLD), parasitic or hydatid (echinococcal) cysts, cystic tumors, and abscesses. These conditions can usually be distinguished on the basis of the patient's symptoms, clinical history, and the radiographic appearance of the lesion, as illustrated in the images below. Ductal cysts, choledochal cysts, and Caroli disease are differentiated from hepatic cysts by involvement of the bile ducts.

Management will be tailored accordingly to the etiology after further work up.

3) Gallbladder Stones / Cholelithiasis

Now the stones in gallbladder are likely reason of pancreatic cysts too. Stones lead to infections like pancreatitis and cholecystitis and they in turn lead to such complications as cysts and fluid collections. Mangement of gallbladder stones is easy. Easily achievable and satisfactory results. All you need is minimal invasive cholecystectomy procedure using laparoscope.

CYsts may also be drained but laproscope after sorting out its etiology. They will self resolve if due to gallbladder issue. If benign they will be left alone as they do no harm and will be monitored in futrue for size change, if any increase in size then will be excised and drained.

pain and bloating and all other symptoms are due to gallbladder and they will self resolve. Just get a hepatobiliary surgeon and what to do next, let him be the judge of that.

I hope it helps. Take good care of yourself and dont forget to close the discussion please.

may the odds be ever in your favour.

Regards
Khan
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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Suggest Treatment For Cysts In Liver, Pancreas And Gallstones

Brief Answer: Cholecystectomy and further management Detailed Answer: Thank you for asking Lets talk about them one by one. 1) Pancreatic Cyst Pancreatic cysts are collections (pools) of fluid that can form within the head, body, and tail of the pancreas. Some pancreatic cysts are true cysts (non-inflammatory cysts), that is, they are lined by a special layer of cells that are responsible for secreting fluid into the cysts. Other cysts are pseudocysts (inflammatory cysts) and do not contain specialized lining cells. The most important aspect of management of pancreatic cysts is the determination of whether a cyst is benign (and usually needs no treatment) or if it is precancerous or cancerous and must be removed. The second most important aspect of management is to determine whether a patient with a precancerous or cancerous pancreatic cyst is a suitable surgical candidate. In medical centers experienced in performing pancreatic surgery, surgical removal of precancerous or cancerous cysts results in a high rate of cure. Very small cysts can be followed to detect an increase in size that may indicate cancer or an increased risk of developing cancer. Not all cysts need to have endoscopic ultrasound or be aspirated; some may have characteristics so suggestive of malignancy that surgery is recommended without endoscopic ultrasound. Others may have characteristics so suggestive of a non-cancerous cyst that no endoscopic ultrasound needs to be done although imaging studies (ultrasound, CT, MRI) may be repeated periodically. There are not yet standard recommendations for managing pancreatic cysts. Different medical centers have adopted different approaches to diagnosis and treatment. Management decisions must be individualized for each patient after discussions with a doctor familiar with the patient's health status. The following is one example of how a doctor might manage pancreatic cysts. Pancreatic pseudocysts need treatment if they persist beyond six weeks after acute pancreatitis, especially if they reach a large size and cause symptoms such as obstruction of the stomach or common bile duct, abdominal pain, or become infected. Small pancreatic cysts (for example, cysts smaller than one cm) will have little chance of being cancerous. Nevertheless, even these small cysts can grow in size and turn cancerous in the future. Thus, these patients are monitored with yearly scans (for example, yearly ultrasound or MRI). The cysts do not have to be evaluated with endoscopic ultrasound and fine needle aspiration. If the cysts grow in size and/or cause symptoms, the patient will be evaluated further using endoscopic ultrasound and fine needle aspiration. Pancreatic cysts larger than 2 cm in young, healthy individuals usually are treated with surgical removal, especially if the cysts produce symptoms. Pancreatic cysts larger than 2 cm in elderly patients can be studied with endoscopic ultrasound and fine needle aspiration. If fluid cytology, CEA measurements or analysis of DNA suggest cancerous or precancerous changes, the patients can be evaluated for pancreatic surgery. 2) Liver cysts hepatic cyst usually refers to solitary nonparasitic cysts of the liver, also known as simple cysts. However, several other cystic lesions must be distinguished from true simple cysts. Cystic lesions of the liver include simple cysts, multiple cysts arising in the setting of polycystic liver disease (PCLD), parasitic or hydatid (echinococcal) cysts, cystic tumors, and abscesses. These conditions can usually be distinguished on the basis of the patient's symptoms, clinical history, and the radiographic appearance of the lesion, as illustrated in the images below. Ductal cysts, choledochal cysts, and Caroli disease are differentiated from hepatic cysts by involvement of the bile ducts. Management will be tailored accordingly to the etiology after further work up. 3) Gallbladder Stones / Cholelithiasis Now the stones in gallbladder are likely reason of pancreatic cysts too. Stones lead to infections like pancreatitis and cholecystitis and they in turn lead to such complications as cysts and fluid collections. Mangement of gallbladder stones is easy. Easily achievable and satisfactory results. All you need is minimal invasive cholecystectomy procedure using laparoscope. CYsts may also be drained but laproscope after sorting out its etiology. They will self resolve if due to gallbladder issue. If benign they will be left alone as they do no harm and will be monitored in futrue for size change, if any increase in size then will be excised and drained. pain and bloating and all other symptoms are due to gallbladder and they will self resolve. Just get a hepatobiliary surgeon and what to do next, let him be the judge of that. I hope it helps. Take good care of yourself and dont forget to close the discussion please. may the odds be ever in your favour. Regards Khan