[Therapeutic ultrasonography in case of chronic pancreatic cysts]

Since 1975, it has become possible to drain cysts associated with chronic pancreatitis percutaneously under sonographic guidance. Thirty-seven cysts in 35 patients have been punctured by this method. After a 23-month follow-up, 24% of the patients were considered completely healed while 35% did not present with pain again. Failure of the treatment was observed in 41% of the patients (relapse ranging from 2 days to 10 months). We observed no mortality and a 14% morbidity rate. Repetition of puncture did improve the clinical result; this latter cannot be predicted by the existence or not of a communication with the ductal system. Large cysts located in the head of the pancreas and hemorrhagic cysts relapsed systematically and must be considered a contraindication for this treatment. By contrast, primary or secondary infection of the cystic content did not appear to be predictive failure factors. This method should be used, in a first approach, for small cysts in the head of the pancreas or for cysts in the body of the tail that do not bulge into the digestive tract.