Outcome of pseudocysts complicating chronic pancreatitis

Pancreatic pseudocysts are frequent complication of chronic pancreatitis with incidence rate from 20 to 40%. The aim of our study was to establish a possible correlation between clinical features and outcome of pseudocysts complicating chronic pancreatitis.

We included in the study 37 patients with chronic pancreatitis and pancreatic pseudocysts treated at the Department of Digestive Tract Diseases of Lodz Medical University between 2003-2008. For each patients the following parameters were recorded: number and location of pseudocysts, diameter, kind of treatment, recurrence rate and time of hospitalisation.

The mean size of pancreatic pseudocysts was 7.8 cm (range 2-16 cm). Spontaneous regression was observed in 7 pseudocysts (18.9%), persistence without symptoms and without size enlargement in 9 patients (24.3%). Twenty one (56.8%) pseudocysts required therapeutic intervention: endoscopic procedures (27.1%), surgical treatment (18,.9%) or percutaneous drainage (10.8%). Mean pseudocyst size for conservative treated patients was 4.2 compared to 9.6 for patients with interventional treatment (p < 0.05). The overall recurrence rate was 33.3%. The mean hospital stay of patients treated endoscopically was significantly shorter than those treated surgically (p < 0.01) and shorter than those of percutaneous drainage (p < 0.01).

Pseudocysts treatment in chronic pancreatitis may be effectively achieved by both endoscopic and surgical means. Nonetheless, the endoscopic drainage, with lower hospitalization period, should be considered for initial therapy in each appropriate patients.