Current management of pancreatic pseudocysts

Between 1980 and 1995, we treated 98 patients with pancreatic pseudocysts. The aim of this study was to determine the time and indices for both surgical and non-surgical management of pancreatic pseudocysts.

Evaluate the results of treatment of 98 patients with pancreatic pseudocysts.

Resolution of the pseudocyst occurred in 20.4% of cases, after intensive therapy, with satisfactory clinical follow-up. Transcutaneous drainage was used in 38.8% of patients. In 93.3% of cases of immature pancreatic pseudocyst, transcutaneous drainage was effective. Patients who eventually underwent an operation tended to have larger pseudocysts than patients managed non-operatively. Fifty patients underwent primary operative therapy, with 36% undergoing emergency operations for pseudocyst-related complications. Eighty-three per cent of cases of external drainage resulted in postoperative complications.

Small pseudocysts can be resolved with treatment in the early stages of development. Surgical treatment of patients with immature pseudocysts is necessary when complications develop. Internal drainage is the operation of choice for the treatment of mature pseudocysts without complications.