A Clinical Review of the Treatments of Pancreatic Pseudocyst

Lee, Hyung Beom; Lee, Jong Soo

Abstract

This is a retrospective clinical analysis of 27 cases of pancreatic pseudocysts that were treated at the Department of Surgery, Chung Goo Sung Sim Hospital, from 1988 to 1996. The results are as follows:1) The ratio of males to females was 12.5 :1, and the highest incidence was in the 4th decade. 2) Acute & Chronic Pancreatitis was most frequently associated with pancreatic pseudocysts (72.4%). 3) The most frequent symptom of patients with a pancreatic pseudocyst was abdominal pain (92.5%), and the most common site of the pancreatic pseudocyst was the tail of the pancreas (55.6%). 4) Of the 7 cases involving pseudocysts of less than 5 cm, 6 cases were managed conservatively and 1 case surgically . In the 15 cases with sizes from 5 cm to 10 cm, percutaneous catheter drainage was performed in 7 cases, with sizes larger conservative management in 5 cases and surgical management in 4 cases. In the 5 cases with sizes larger than 10 cm, percutaneous catheter drainage was performed in 3 cases and surgical management in 1 case. 5) Cases involving conservative management and percutaneous drainage (average:31 & 34 days), respectively had shorter hospital stays than surgical menagement (42 days). 6) Complications of pancreatic pseudocysts, such as intra-abdominal abscesses, cutaneous fistulas, pulmonary complications, wound infection, leakage or rupture, etc, were relatively common after surgery. In conclusion, we propose that conservative management and percutaneous catheter drainage are first-line treatment modalities for pancreatic pseudocysts if the clinical conditions of the patient can tolerate them.