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Pancreatic pseudocyst--operative strategy.

C F Frey

    Annals of Surgery
    |November 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    This study reports on 131 patients with pancreatic pseudocysts, detailing operative outcomes and mortality. Surgical management of pseudocysts, particularly incision and drainage, carries risks, while cystogastrostomy and cystojejunostomy are preferred for mature cysts.

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    Area of Science:

    • Gastroenterology
    • Surgical Management
    • Pancreatic Diseases

    Background:

    • Pancreatic pseudocysts are a common complication of pancreatitis.
    • Management strategies vary, impacting patient outcomes.

    Purpose of the Study:

    • To report on the experience with surgical management of pancreatic pseudocysts.
    • To identify factors influencing operative mortality and pseudocyst recurrence.

    Main Methods:

    • Retrospective review of 131 patients with 157 pseudocysts.
    • Analysis of operative procedures, complications, and mortality.
    • Emphasis on the role of visceral angiography.

    Main Results:

    • Operative mortality was 8.3%, with higher rates for incision and drainage and cystoduodenostomy.

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  • Postoperative hemorrhage, common duct obstruction, and cyst location in the head/uncinate process were associated with increased mortality.
  • Pseudoaneurysms, identified via visceral angiography, increase hemorrhage risk.
  • Incision and drainage led to high recurrence rates; cystogastrostomy and cystojejunostomy are preferred for mature cysts.

    • Conclusions:

    • Surgical approach for pancreatic pseudocysts should be tailored to cyst maturity and associated complications.
    • Visceral angiography is crucial for identifying pseudoaneurysms, guiding surgical decisions.
    • Cystogastrostomy and cystojejunostomy are recommended for mature pseudocysts to minimize recurrence and improve outcomes.