title: Pancreatic pseudocysts following acute pancreatitis: risk factors influencing therapeutic outcomes.
abstract: BACKGROUND
  The natural history of pancreatic pseudocysts has become well known in recent years, but the choice of a proper treatment still remains controversial.
  
  
  OBJECTIVE
  This study aims at establishing whether predictive factors influencing therapeutic outcomes exist.
  
  
  METHODS
  Patients with pancreatic pseudocysts following an episode of acute pancreatitis treated from January 1980 to December 2001 at the Department of General Surgery and Organ Transplantation of the University of Parma, Italy.
  
  
  METHODS
  Seventy-four patients were studied: 12 had a spontaneous resolution, 37 patients were treated surgically, 15 were treated endoscopically and in 10, percutaneous drainage was used.
  
  
  METHODS
  Epidemiological, clinical and pathological characteristics of patients with pancreatic pseudocysts were related to morbidity, recurrence rates and hospital stay.
  
  
  RESULTS
  At univariate logistic regression, our data reveal a significant increase in morbidity related to age (P=0.013), etiology (alcoholic vs. biliary, P=0.024), Ranson score of previous pancreatitis (P=0.006), nutritional assessment (P=0.001), residual necrosis (P<0.001) and modality of treatment (P=0.009), whereas none of these parameters has been shown to be significantly correlated to recurrence. At multivariate logistic regression, only residual necrosis was significantly related to morbidity.
  
  
  CONCLUSIONS
  Some factors, such as epidemiological (age, etiology), clinical (severity of previous pancreatitis, malnourishment), pathological (residual necrosis), and therapeutical factors (emergency/urgency treatment) are predictive of worse outcomes for invasive treatment of pseudocysts. In particular residual necrosis appeared to be the most important factor influencing invasive treatment outcomes, confirming that this pathological aspect deserves particular attention from surgeons. No risk factors predicting pancreatic pseudocyst recurrence emerged.
authors.affiliation: Department of General Surgery and Organ Transplantation, University of Parma, Parma, Italy. paolo.soliani@unipr.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Soliani
authors.forename: Christian
authors.initials: C
authors.lastname: Franzini
authors.forename: Stefanie
authors.initials: S
authors.lastname: Ziegler
authors.forename: Paolo
authors.initials: P
authors.lastname: Del Rio
authors.forename: Paolo
authors.initials: P
authors.lastname: Dell'Abate
authors.forename: Davide
authors.initials: D
authors.lastname: Piccolo
authors.forename: Gioacchino Giovanni
authors.initials: GG
authors.lastname: Japichino
authors.forename: Giulia Martina
authors.initials: GM
authors.lastname: Cavestro
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Mario
authors.forename: Mario
authors.initials: M
authors.lastname: Sianesi
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods / Q000401:mortality; D004322:Drainage / Q000379:methods / Q000401:mortality; D016099:Endoscopy, Gastrointestinal / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000453:epidemiology*; D010195:Pancreatitis / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome