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The extent and perioperative risk of resections of PCL in Germany needs comparison with these guidelines to highlight controversies and derive recommendations.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Clinical data of 1137 patients who underwent surgery for PCL between 2014 and 2019 were retrieved from the German StuDoQ|Pancreas registry. Relevant features for preoperative evaluation and predictive factors for adverse outcomes were statistically identified.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Patients with intraductal papillary mucinous neoplasms (IPMN) represented the largest PCL subgroup (<jats:italic>N<\/jats:italic>\u2009=\u2009689; 60.6%) while other entities (mucinous cystic neoplasms (MCN), serous cystic neoplasms (SCN), neuroendocrine tumors, pseudocysts) were less frequently resected. Symptoms of pancreatitis were associated with IPMN (<jats:italic>OR<\/jats:italic>, 1.8; <jats:italic>P<\/jats:italic>\u2009=\u20090.012) and pseudocysts (<jats:italic>OR<\/jats:italic>, 4.78; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), but likewise lowered the likelihood of MCN (<jats:italic>OR<\/jats:italic>, 0.49; <jats:italic>P<\/jats:italic>\u2009=\u20090.046) and SCN (<jats:italic>OR<\/jats:italic>, 0.15, <jats:italic>P<\/jats:italic>\u2009=\u20090.002). A total of 639 (57.2%) patients received endoscopic ultrasound before resection, as recommended by guidelines. Malignancy was histologically confirmed in 137 patients (12.0%), while jaundice (<jats:italic>OR<\/jats:italic>, 5.1; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and weight loss (<jats:italic>OR<\/jats:italic>, 2.0; <jats:italic>P<\/jats:italic>\u2009=\u20090.002) were independent predictors. Most resections were performed by open surgery (<jats:italic>N<\/jats:italic>\u2009=\u2009847, 74.5%), while distal lesions were in majority treated using minimally invasive approaches (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Severe morbidity was 28.4% (<jats:italic>N<\/jats:italic>\u2009=\u2009323) and 30d mortality was 2.6% (<jats:italic>N<\/jats:italic>\u2009=\u200929). Increased age (<jats:italic>P<\/jats:italic>\u2009=\u20090.004), higher BMI (<jats:italic>P<\/jats:italic>\u2009=\u20090.002), liver cirrhosis (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and esophageal varices (<jats:italic>P<\/jats:italic>\u2009=\u20090.002) were independent risk factors for 30d mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>With respect to unclear findings frequently present in PCL, diagnostic means recommended in guidelines should always be considered in the preoperative phase. The therapy of PCL should be decided upon in the light of patient-specific factors, and the surgical strategy needs to be adapted accordingly.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00423-022-02740-0","type":"journal-article","created":{"date-parts":[[2023,1,14]],"date-time":"2023-01-14T06:02:27Z","timestamp":1673676147000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Surgical treatment for pancreatic cystic lesions\u2014implications from the multi-center and prospective German StuDoQ|Pancreas registry"],"prefix":"10.1007","volume":"408","author":[{"given":"Jonas","family":"Henn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia K.","family":"Wyzlic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Esposito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Semaan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vittorio","family":"Branchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Klinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heinz J.","family":"Buhr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich F.","family":"Wellner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Keck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Lingohr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim R.","family":"Glowka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Manekeller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg C.","family":"Kalff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanno","family":"Matthaei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the StuDoQ|Pancreas Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,1,14]]},"reference":[{"key":"2740_CR1","doi-asserted-by":"publisher","first-page":"2079","DOI":"10.1038\/ajg.2010.122","volume":"105","author":"KS Lee","year":"2010","unstructured":"Lee KS, Sekhar A, Rofsky NM, Pedrosa I (2010) Prevalence of incidental pancreatic cysts in the adult population on MR imaging. 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PL has, in the past, received travel support payments from Medtronic plc., Dublin, Ireland, Ethicon inc., Bridgewater, US and KARL STORZ SE & Co. KG, Tuttlingen, Germany, and is currently employed by the German Society of General and Visceral Surgery (DGAV) for audits. For the remaining authors (JH, PKW, IE, AS, VB, CK, HJB, UFW, TRG, SM, JCK, HM) none were declared.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Patients signed informed consent for anonymized participation in the registry and the Ethics Committee, University of Bonn, Germany, approved the present study (#498\/20).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"TK has received payments for lectures from Intuitive Surgical Inc., Sunnyvale, US. PL has, in the past, received travel support payments from Medtronic plc., Dublin, Ireland, Ethicon inc., Bridgewater, USA, and KARL STORZ SE & Co. KG, Tuttlingen, Germany, and is currently employed by the German Society of General and Visceral Surgery (DGAV) for audits. For the remaining authors (JH, PKW, IE, AS, VB, CK, HJB, UFW, TRG, SM, JCK, HM) none were declared.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"28"}}