Evaluation of therapeutic options for pancreatic pseudocysts.
A review of 81 patients with pancreatic pseudocyst was conducted to assess the value of different treatment modalities. Resection was associated with 18% mortality (two of 11 patients) and 36% morbidity. In three of nine patients undergoing external drainage a recurrent pseudocyst developed, and in one additional patient, a pancreatic fistula persisted. Internal drainage by cystogastrostomy (21 patients) resulted in 9.5% mortality and 9.5% morbidity, whereas cystojejunostomy (33 patients) was associated with a 6% mortality and 6% morbidity. Endoscopic drainage through the posterior wall of the stomach was unsuccessful in the two patients in which it was used. Internal drainage into the stomach, duodenum, or jejunum is a safe and effective approach for most pseudocysts. Persistent symptoms following surgical treatment were primarily related to failure to recognize multiple cysts and/or pancreatic duct obstruction and dilation characteristic or chronic pancreatitis.
D000328:Adult; D000368:Aged; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery; D010181:Pancreatic Cyst / Q000601:surgery*; D010192:Pancreatic Pseudocyst / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications