[Diagnosis and surgical management of pancreatic pseudocysts]

Fifty-two patients with pancreatic pseudocysts were treated surgically between 1968 and 1994. Clinical symptoms were non-specific. Ten patients with acute pancreatitis were managed conservatively and resolution occurred in 3 patients. 42 patients underwent operation. Internal drainage was performed in 28 patients, external drainage in 8, others in 6. Pancreatic fistulas occurred in the external drainage group, 2 patients died and 1 patient had the of recurred pseudocyst. There were no complications in the internal drainage group. It was quite different in the external drainage group. The management should differ in that acute and chronic pancreatic pseudocysts. Patients with pseudocysts of chronic pancreatitis could undergo emergent surgery of internal drainage because waiting 6 weeks for maturation of the pseudocysts after diagnosis was unnecessary and even hazardous. However, if pseudocyst developed after acute pancreatitis, it should be watched for up to 6-8 weeks. During this period the pseudocyst perhap disappeared spontanously or matured for surgery.