A comparison between surgical, endoscopic and percutaneous management of pancreatic pseudocysts--long term results

In a retrospective study, the data of 127 patients who had been treated in our hospital between 1985 and 1990 for pancreatic pseudocysts were re-examined and analysed in order to evaluate the therapeutic success. In 13 cases (10%), a spontaneous regression was observed. Forty-four patients (35%) were treated surgically, 37 (29%) were managed endoscopically and 7 (6%) received a percutaneous treatment. The remaining 26 patients (20%) had received a combined form of therapy either primarily or later within the course of their treatment. After an average period of 33 months, 97 patients could be either re-questioned or re-examined. The results showed that 50% of the patients treated surgically and 52% of those treated endoscopically were without complaints. The over-all mortality rate was 9%. A lack of success following various therapeutic regimes resulted in up to 20% of all patients. In summary, endoscopic drainage proved to be a simple method with a low complication rate and an alternative to internal surgical drainage particularly for persistent alcoholics and patients over 65 years of age. Endoscopic drainage is not an alternative for patients with persistent abdominal pain symptoms or complications.