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Abstract

Epidemiological studies on pancreatic pseudocysts are retrospective analyses on alcoholic patients. The aims of this study were to investigate the incidence, natural history, and predictors of the appearance and disappearance of pancreatic fluid collections and pseudocysts after nonalcoholic acute pancreatitis. We carried out a prospective cohort study in a series of 926 patients with acute pancreatitis. Pancreatic fluid collections or pseudocysts were treated only after complications. We studied pancreatic fluid collections from 83 patients (8.9%): 48 of whom developed pseudocysts (5.1%). Both were less frequent after biliary pancreatitis (P < 0.0001). In the first 60 days of follow-up, patients with fluid collections or pseudocysts showed more complications than spontaneous disappearance; two of them died. After the 60th day, spontaneous disappearance was more frequent, and at one year the cumulative incidence of complications and spontaneous disappearance was 36% and 56%, respectively. A total of 33 patients with fluid collection needed interventional treatment (surgery or percutaneous or endoscopic drainage). Pseudocysts that were small (<5 cm) or developed in the tail had a higher incidence of spontaneous disappearance: 22/24 (91.7%) and 11/12 (91.7%), respectively. In conclusion, fluid collections and pseudocysts after non-alcoholic pancreatitis have a low incidence of complications and mortality with a high rate of spontaneous disappearance. We suggest treating them only after complications.

Management of patients after recovering from acute severe biliary pancreatitis

“…Management of pseudocysts and walled-off necrosis according to management plans: Most of the fluid collections generally resolve spontaneously without the need for further intervention, but 5%-16% of patients with severe acute pancreatitis will develop a pseudocyst > 4 wk after onset of pancreatitis[57,58]. The prevalence in biliary pancreatitis is 6%-8%[59].…”

Update of the Atlanta Classification of Severity of Acute Pancreatitis: Should a Moderate Category Be Included?

“…In different studies of natural history, the presence of this complication is associated with the need of invasive treatment in a high percentage of cases [24,25]. This complication may be associated with symptoms such as pain, abdominal compression and complications that might be serious such as infection, rupture, pseudoaneurysm, etc.…”

Laparoscopic Transgastric versus Endoscopic Drainage of a Large Pancreatic Pseudocyst. A Case Report

“…Pancreatic pseudocysts are the most common complication of acute and chronic pancreatitis [1], with an incidence of 14.6% in acute pancreatitis and 41.8% in acute-on-chronic pancreatitis [2][3][4][5]. They account for 75% of the cystic lesions of the pancreas [6].…”