Percutaneous catheter drainage in pancreatic pseudocysts

Percutaneous catheter drainage (PCD) was performed in 12 pancreatic pseudocysts in 11 patients. The procedure was performed under realtime ultrasound guidance adopting a direct transperitoneal approach in all cases. Complete cure was achieved in 9 (75%) of the Pseudocysts drained. Success rate was higher in pseudocysts not communicating with the main pancreatic duct (MPD), 7 of 8 (87.5%) as compared to those with ductal communication, 2 of 4 (50%). The mean duration of catheter drainage was 14.2 days in the first group while it was significantly longer, (42.5 days) in the latter group. No death or major complication related to the procedure was encountered in the study. A single pseudocyst got infected after catheter insertion but it was treated successfully with antibiotics. The follow up period was 3-18 months with a mean of 6.8 months. PCD failed in 2 pseudocysts communicating with MPD and associated strictures in the MPD. In one case having no communication with MPD the procedure failed because the cyst had thick debris which could not be drained properly. PCD may be a safe and effective therapy in the management of pseudocysts with best results in those not communicating with the MPD. Communicating pseudocysts, also having strictures in MPD, should not be subjected to PCD.