Pancreatic pseudocysts in chronic pancreatitis. Surgical or interventional drainage?
Pseudocyst formation is a well-known complication of acute and chronic pancreatitis. Many pseudocysts are asymptomatic and may resolve without intervention. For a symptomatic pseudocyst drainage is indicated. Although surgical cystoenterostomy has been the treatment of choice for many years, recently invasive but non-operative treatment methods have challenged surgical drainage as the standard therapy for pancreatic pseudocysts. Both the method as well as the timing of intervention has become a matter of debate. Percutaneous catheter drainage and endoscopic drainage have proven beneficial in the treatment of pseudocysts, although long-term outcome remains to be awaited. Resolution rates after surgical and non-surgical methods are comparable, but clinical and technical aspects may mandate either method. Each patient requires an individual, multidisciplinary approach, thereby obtaining optimal treatment-outcome.
Boerma
D
D
Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands. d.boema@amc.uva.nl
Obertop
H
H
Gouma
D J
DJ
D002908:Chronic Disease; D004322:Drainage / Q000379:methods; D006801:Humans; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010195:Pancreatitis / Q000150:complications / Q000601:surgery*