[Evaluation and selection of different procedures in the treatment of pancreatic pseudocyst].
OBJECTIVE
To evaluate the effect of different procedures in the treatment of pancreatic pseudocyst.


METHODS
This retrospective review analyzed the outcome of 114 patients with pancreatic pseudocysts managed in PUMC Hospital from January 1990 to March 2002.


RESULTS
There were 25 patients without intervention, the spontaneous resolution of pseudocysts occurred in 23 of these patients during follow up. Twenty-nine cases underwent CT-guided percutaneous catheter drainage; the effective rate of therapy was 67.85%. Surgical procedures performed in 60 cases and the overall mortality was 5% (3/60). The procedures included external drainage (8 cases) with 1 death (12.5%), excision (13 cases), cyst-duodenostomy (1 cases), cyst-gastrostomy (19 cases) with 7 postoperative gastrointestinal bleeding (36.8%) and 1 death (5.26%), Roux-en-Y cyst-jejunostomy (19 cases) with 3 postoperative gastrointestinal bleeding (15.8%) and 1 death (5.26%).


CONCLUSIONS
CT-guided percutaneous catheter drainage has the advantage of minimal invasive and simple technique; it can be as an effective substitute method of traditional open external drainage. Although minimally invasive techniques offer a variety of treatment options, surgical procedures are still indicated for significant number of patients. The incidence of postoperative gastrointestinal bleeding in cyst-gastrostomy was higher than those patients with Roux-en-Y cyst-jejunostomy, but most of them were not difficult to treatment, so cyst-gastrostomy is still a simple and reasonable procedure for selected patients. Excision is a correct choice for cases in which pseudocysts cannot be differentiated from neoplastic cysts.
Zhang
Tai-Ping
TP
Department of Surgery, Peking Union Medical College Hospital, Beijing 100730, China. andrewzhangt@yahoo.com.cn
Zhao
Yu-Pei
YP
Yang
Ning
N
Liao
Quan
Q
Pan
Jie
J
Cai
Li-Xing
LX
Zhu
Yu
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D004322:Drainage / Q000379:methods; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010192:Pancreatic Pseudocyst / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome