[Drainage treatment of pancreatic pseudocysts]

Between 1967 and 1980 a total of 153 benign pancreatic pseudocysts were operatively treated in 148 patients. Most frequently drainage of the cyst into the small intestine with a Roux-en-y loop was effected. The operative mortality with this method was 5.8%. The total operative mortality was 6.8%. The recurrence rate in all surviving patients was 32.6% during a mean observation period of 56.4 months. There was a correlation between the incidence of recurrence and the etiology of the cyst (chronic, acute and traumatic pancreatitis). Patients in whom the pseudocyst arose from chronic pancreatitis had a recurrence rate of 41.4% as compared to 17.8% in patients with cysts developing after acute pancreatitis. This difference is even more pronounced in the group of the 120 patients in whom a cystojejunostomy was performed. The total recurrence rate of 31.9% is mainly caused by patients with chronic pancreatitis who suffered a relapse in 43.8%. The cysts developing after acute pancreatitis on the other hand had a recurrence rate of only 8.6%. It is concluded that internal drainage of the pancreatic pseudocyst by cystojejunostomy with a Roux-en-y loop is justified in post-traumatic cysts and in those arising after acute pancreatitis. Pseudocysts associated with chronic pancreatitis on the other hand should be resected whenever possible.