[Surgical aspect in the management of pancreatic pseudocyst]

During the years from 1969 to 1979, 35 patients were operated 36 occasioned by pancreatic pseudocysts in the Department of Surgery of the University Hospital of Göettingen, West Germany. They were utilized as diagnostic methods laboratory exams, especially serial seric and urinary amylase as creatinine and at the same time abdominal echography, upper gastrointestinal tract X-rays, thorax X-rays, Barium Enema and Biliary tract X-rays. Although the great number of transit accidents, the traumatic pancreatic pseudocysts were seldom found and most of them were operated as a result of a chronic pancreatitis. Contrarily the pancreatic pseudocysts as result of an acute pancreatitis and recurrent acute pancreatitis were in a limited number. We observed only 2 cases of acute pancreatitis with biliary etiology. We realized one operation in 31 cases and in one resection, four of the series, was the only occasion that we recurred for a second and a third operation. The external drainage was realized exclusively in 3 cases while internal drainage was performed 28 times. The surgical technic frequently used as internal drainage was the Roux en-Y Cystojejunostomy and was perfomed in 21 patients. This method demonstrated to be the most fit by morphologic as functional reasons. We observed that our mortality was null and our post-operative morbility was minimal, so, we have only 3 patients with complicated post-operative course. The mean hospitalization time was 25 days. We surgical treatment of choice for the drainage of the pancreatic pseudocysts.