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Updated: May 15, 2026
Retroperitoneal Laparoscopic Debridement and Drainage for Pancreatic Abscess
Published on: March 15, 2024
Non-operative treatment versus percutaneous drainage of pancreatic pseudocysts in children
K W Russell1, D C Barnhart, J Madden
1Department of Surgery, University of Utah, Salt Lake City, UT 84113, USA. Katie.Russell@hsc.utah.edu
Insights
Pediatric pancreatic pseudocysts often resolve without surgery. Percutaneous drainage is a successful initial intervention, frequently avoiding the need for major surgical procedures in children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Pancreatic pseudocysts are a known complication in children.
- Management strategies vary, with a need to define optimal approaches.
Purpose of the Study:
- To characterize the clinical course and outcomes of pediatric pancreatic pseudocysts.
- To evaluate the efficacy of non-operative and percutaneous drainage treatments.
Main Methods:
- Retrospective review of pediatric patients with pancreatic pseudocysts over 12 years.
- Statistical analysis including Fischer's exact test, Student's t test, logistic, and linear regression.
Main Results:
- 33 children were treated non-operatively or with percutaneous drainage.
- 77% of non-operatively managed pseudocysts and 72% of percutaneously drained pseudocysts resolved without further intervention.
- Pseudocyst size or complexity did not predict treatment success.
Conclusions:
- Non-operative management is frequently successful for pediatric pancreatic pseudocysts, irrespective of size or complexity.
- Percutaneous drainage is an effective initial intervention, often obviating the need for major surgery.
Purpose:
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.
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