Postacute pancreatic pseudocysts: definition and operative treatment

Authors survey earlier definitions of classification of pancreatitis (Symposiums in Marseilles, 1963, Cambridge, 1983, Marseilles, 1984). They define the concept of postacute pancreatic pseudocyst based on their own clinical practice, describe its clinical view and characteristic signs. They noticed in 90 cases (9%) postacute pancreatic pseudocysts during 991 pancreatic pseudocyst operations at 850 patients in 5-year period in their own practice. That postacute pseudocysts were found 6 weeks after severe acute pancreatitis in patients who were clinically in recovering state, feverless and alimented orally. The operative treatment of postacute pseudocysts was in 70% outer drainage (in 58 cases from 63 were performed necrectomy, too), in 14% (13 cases) inner drainage and in 16% resection (from 14 cases 11 distal resections, 10 times associated with splenectomy). The chosen operative treatment was significantly (p < 0.01) more outer drainage and less inner drainage. The mortality and morbidity indexes of postacute pancreatic pseudocysts did not deviate significantly from the same values of the whole patient material.