[Pancreatic pseudocyst--diagnosis, evolution, surgical treatment]

The pancreatic pseudocyst (PP) represents one of the most common complications of acute and chronic pancreatitis, patients with this severe pathology often undergoing surgical treatment.

This paper evaluates 133 cases that underwent surgical procedures for PP in the 3rd Surgical Clinic Cluj-Napoca during January 1993-April 2003, from a diagnostic and therapeutic point of view, emphasizing the modern imagistic methods for diagnosis and the modern surgical approach to PP.

In 105 cases (79%) an internal drainage procedure was performed (including three cases that underwent laparoscopic drainage procedures and one case undergoing a laparoscopy assisted drainage procedure, all four cases with favorable postoperative outcome), external drainage procedures were performed in 25 cases (19%) and in three cases (2%) a pancreatic resection was performed. External drainage was performed only when internal drainage was not possible. Postoperative complications occurred only in patients with externally drained PP.

The results of this study confirm that the internal drainage of PP, especially using the limb of jejunum Roux-en-Y technique (67 cases, 50%), represents the best approach to PP surgery, laparoscopic procedures being a valid option in performing an internal drainage.