Pseudocysts of the pancreas, a review of 97 cases

Pseudocysts represent a relatively common problem in the management of patients with pancreatic disease. In evaluating the outcome of treatment, many authors have failed to differentiate between those pseudocysts that follow an attack of acute pancreatitis and those that occur with established chronic disease. We retrospectively reviewed the outcome of treatment in 97 patients admitted to the University of Virginia Hospital in Charlottesville over a 6-year period with a diagnosis of pancreatitis pseudocyst. In 50 of the 97 patients (52%), the pancreatic pseudocyst followed an attack of acute pancreatitis, and 47 (48%) patients had chronic disease. The mean age at presentation was 48.6 +/- 16.4 years for the entire group. Twenty-four patients (25%) were black, and 73 (75%) were white. Sixty-four patients were male (66%), and 33 were female (34%). Alcohol was the important etiological agent in 30 of the 47 patients with chronic pancreatitis (64%), but only 13 of the 50 patients (26%) with acute pancreatitis. By comparison, gallstones were the precipitating cause in 13 of the 50 patients with acute pancreatitis (26%), but only 5 of the 47 patients (11%) with chronic pancreatitis. Thirty-one patients (32%) were treated by observation, 37 patients (36%) by percutaneous aspiration or drainage, and 46 patients (47%) by surgical drainage or resection. Some patients fell into more than one category. Our findings suggested that many patients with small cysts (less than 6 cm) can be managed by a period of observation.(ABSTRACT TRUNCATED AT 250 WORDS)