title: Non-operative treatment versus percutaneous drainage of pancreatic pseudocysts in children.
abstract: OBJECTIVE
  The objective of this study was to characterize the clinical course and outcomes of children with pancreatic pseudocysts that were initially treated non-operatively or with percutaneous drainage.
  
  
  METHODS
  A retrospective review of children with pancreatic pseudocysts over a 12-year period was completed. Categorical variables were compared using Fischer's exact method and the Student's t test was used to compare continuous variables. Analysis was done using logistic and linear regression models.
  
  
  RESULTS
  Thirty-six children met the criteria for pancreatic pseudocyst and 33 children were treated either non-operatively or with percutaneous drainage. Of the 22 children managed non-operatively, 17 required no additional intervention (77 %) and five required surgery. Operative procedures were: Frey procedure (3), distal pancreatectomy (1), and cystgastrostomy (1). Eight of the 11 children treated with initial percutaneous drainage required no additional treatment (72 %). The other three children underwent distal pancreatectomy. Success of non-operative management or percutaneous drainage was not dependent on size or complexity of the pseudocyst Logistic regression did not identify any patient demographic (gender, age, and weight), etiologic (trauma, non-traumatic pancreatitis) or pseudocyst characteristic (size, septations) that predicted failure of non-operative therapy.
  
  
  CONCLUSIONS
  In children, pancreatic pseudocysts can frequently be managed without surgery regardless of size or complexity of the pseudocyst. When an intervention is needed, percutaneous drainage can be performed successfully, avoiding the need for major surgical intervention in the majority of patients.
authors.affiliation: Department of Surgery, University of Utah, Salt Lake City, UT 84113, USA. Katie.Russell@hsc.utah.edu
authors.forename: K W
authors.initials: KW
authors.lastname: Russell
authors.forename: D C
authors.initials: DC
authors.lastname: Barnhart
authors.forename: J
authors.initials: J
authors.lastname: Madden
authors.forename: E
authors.initials: E
authors.lastname: Leeflang
authors.forename: W D
authors.initials: WD
authors.lastname: Jackson
authors.forename: G P
authors.initials: GP
authors.lastname: Feola
authors.forename: R L
authors.initials: RL
authors.lastname: Meyers
authors.forename: E R
authors.initials: ER
authors.lastname: Scaife
authors.forename: M D
authors.initials: MD
authors.lastname: Rollins
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D010180:Pancreatectomy; D010192:Pancreatic Pseudocyst / Q000209:etiology / Q000628:therapy*; D010193:Pancreaticojejunostomy; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult