[Is there still a place for surgery in the treatment of communicating pseudocyst in chronic pancreatitis?].
The purpose of this study was to evaluate the results of long term percutaneous catheter drainage in the treatment of chronic pancreatic pseudocysts communicating with pancreatic ducts. Since 1986, 13 consecutive patients with symptomatic pseudocysts were treated prospectively. All pseudocysts were associated with chronic pancreatitis. The location was head (n = 8), body (n = 3) or tail (n = 2). The procedure included fine needle aspiration under ultrasonic control, percutaneous drainage along a guide wire and closed suction aspiration. A radiological control was performed weekly and the catheter was left in place until total resolution of pseudocyst. Immediate relief of pain and resolution of pseudocyst were obtained in all 13 patients. The average length of hospital stay was 12.2 +/- 8 days (1 to 23). The average duration of drainage was 36 days. There was no mortality of morbidity related to the drainage. There were two asymptomatic recurrences, but long-term follow-up (mean 3 years) showed that all 13 patients were symptom-free. The clinical results of such a long-term catheter drainage seem better in our study than in other previous series. It is a simple and innocuous procedure, and could be carried out in an outpatient unit. Such drainage represents an efficient alternative to endoscopic or surgical treatment of chronic pancreatic pseudocyst with ductal communication. In our experience surgery is no longer indicated.
Delattre
J F
JF
Service de Chirurgie Générale, Hôpital Robert-Debré, Reims.
Bouche
O
O
Avisse
C
C
Palot
J P
JP
Flament
J B
JB
D000328:Adult; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010195:Pancreatitis / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
Reste-t-il une place pour la chirurgie dans le traitement des pseudo-kystes communicants de la pancréatite chronique?