Pancreatic pseudocyst: Dilemma of its recent management (Review)

Tan, Jonathan Hartanto; Chin, Wenjie; Shaikh, Abdul Lateef; Zheng, Shusen

doi:10.3892/etm.2020.9590

Cited by 29 publications

(41 citation statements)

References 53 publications

(70 reference statements)

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“…[12,13] Nevertheless, pancreatic pseudocysts represent more than 75% of cystic lesions of the pancreas. [6,14,15]…”

Section: Discussionmentioning

confidence: 99%

“…[5,8,17] Computed Tomography [CT] scan is also useful in the differential diagnosis between pseudocysts and walled-off necrosis, offering recognition of solid components and debris. [2,14] Lastly, CT is able to supply information regarding the common bile duct, the pancreatic duct and the presence or absence of pancreatic necrosis. [14] Abdominal Ultrasound is a suitable radiographic modality for follow-up assessment of interval changes in size.…”

Section: Figure 3 Computed Tomography Demonstating Complete Remission Of the Pseudocystmentioning

confidence: 99%

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Treatment of oversize and recurrent pancreatic pseudocyst after an episode of acute pancreatitis: a case report and review management

2021

IJCR

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Pancreatic cysts are being diagnosed more frequently because of the increasing usage of multiple noninvasive imaging modalities. Moreover, pancreatic pseudocysts (PPs) present a challenging problem for physicians dealing with pancreatic disorders, especially in cases where their treatment will be required. The diagnosis of a PP needs imaging with ultrasonography, Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI). In most cases, pancreatic pseudocysts are asymptomatic and resolve spontaneously. [1-3] Asymptomatic PPs up to 6 cm in diameter can be safely observed and monitored with serial imaging.[1] If they evolve and increase in size, they become symptomatic through compression of the adjacent organs and need interven-tion.[1, 4-6] Their management demands the cooperation of surgeons, radiologists and gastroenterolo-gists. The treatment of PPs has evolved considerably over the past decade, moving from what was once open surgical management to increasingly minimally invasive techniques, both by surgery and by endoscopy. Thus, many studies have reported successful drainage through the use of various techniques.[1, 3, 4] However, the absence of a large number of cases as well as guidelines for dealing with them raise even today dilemmas regarding the treatment of choice. Here we present a case of a large pancreatic pseudocyst and a brief review of the literature.

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“…[12,13] Nevertheless, pancreatic pseudocysts represent more than 75% of cystic lesions of the pancreas. [6,14,15]…”

Section: Discussionmentioning

confidence: 99%

Section: Figure 3 Computed Tomography Demonstating Complete Remission Of the Pseudocystmentioning

confidence: 99%

Treatment of oversize and recurrent pancreatic pseudocyst after an episode of acute pancreatitis: a case report and review management

2021

IJCR

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“…In addition, the complications during prolonged observation of PPC in the expectation of spontaneous resolution were infrequent and treatable. Even though some centers once held the position statement that pseudocysts with a size above 60 mm and do not resolve within 6 wk should be treated[ 8 , 11 , 12 ], the indication of treating pseudocyst based on size and duration should be abandoned due to the knowledge of the natural history of PPC. According to the American College of Gastroenterology guidelines[ 13 ], asymptomatic PPC do not warrant intervention regardless of size, location, and/or extension.…”

Section: Pancreatic Pseudocystmentioning

confidence: 99%

Current status of treatments of pancreatic and peripancreatic collections of acute pancreatitis

Xiao

Cui

Liu

et al. 2021

WJGS

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Pancreatic and peripancreatic collections are the main local complications of acute pancreatitis with a high incidence. In the early phase, most acute pancreatic and peripancreatic collections can resolve spontaneously with supportive treatment. However, in some cases, they will develop into pancreatic pseudocyst (PPC) or walled-off necrosis (WON). When causing symptoms or coinfection, both PPC and WON may require invasive intervention. Compared to PPC, which can be effectively treated by endoscopic ultrasound-guided transmural drainage with plastic stents, the treatment of WON is more complicated and challenging, particularly in the presence of infected necrosis. In the past few decades, with the development of minimally invasive interventional technology especially the progression of endoscopic techniques, the standard treatments of those severe complications have undergone tremendous changes. Currently, based on the robust evidence from randomized controlled trials, the step-up minimally invasive approaches have become the standard treatments for WON. However, the pancreatic fistulae during the surgical step-up treatment and the stent-related complications during the endoscopic step-up treatment should not be neglected. In this review article, we will mainly discuss the indications of PPC and WON, the timing for intervention, and minimally invasive treatment, especially endoscopic treatment. We also introduced our preliminary experience in endoscopic gastric fenestration, which may be a promising innovative method for the treatment of WON.

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“…Псевдокиста поджелудочной железы представляет собой ограниченное жидкостное скопление, в котором содержатся амилаза и другие ферменты поджелудочной железы, не содержит солидных компонентов и окружена четко выраженной капсулой, состоящей из фиброзной ткани, без эпителиальной выстилки [1]. Большинство псевдокист поджелудочной железы возникают как исход хронического панкреатита, также они появляются после перенесенного острого панкреатита, травмы поджелудочной железы или после оперативного вмешательства на поджелудочной железе [2,3].…”

Section: Introductionunclassified

Current treatment of pancreatic pseudocysts: a systematic review

Durleshter¹,

Генрих

Макаренко³

et al. 2021

Kuban. nauсh. med. vestnik

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Background. Pancreatic pseudocysts stand among current challenges in modern medicine. Their treatment uses variant instrumental techniques and implies a multispecialty approach. Trials in surgery and gastroenterology have aimed to identify an optimal strategy to tackle pancreatic pseudocysts for reducing complications and the recurrence rate, suggesting ultrasound-guided percutaneous, laparoscopic and flexible endoscopic drainage as promising treatment choices.Objectives. A summarising review of diagnostic and therapeutic methods for pancreatic pseudocyst treatment and comparison of ultrasound-guided percutaneous vs. surgical and endoscopic drainage techniques.Methods. The review examines the classification, epidemiology and methods for diagnosis and treatment of pancreatic pseudocysts. Only comparative full-text studies published within 2014–2021, as well as selected impactive publications within 2002–2013, have been included. The eLibrary, Elsevier and PubMed resources were queried for the article or journal title fields against the keywords (separate or combined) “pancreatic pseudocyst” [псевдокиста поджелудочной железы], “pseudocyst drainage” [дренирование псевдокисты], “surgical drainage” [хирургическое дренирование], “endoscopic drainage” [эндоскопическое дренирование], cystogastrostomy [цистогастростомия], gastrojejunostomy [гастроеюностомия], “duodenal-cystic anastomosis” [цистодуоденоанастомоз], “transpapillary drainage” [транспапиллярное дренирование], “transmural drainage and esophagogastroduodenoscopy” [трансмуральное дренирование и эзофагогастродуоденоскопия]. Records have been selected for topic-related scientific value.Results. The review systematically surveys 68 scientific papers in the focus area and summarises the most common surgical methods for pancreatic pseudocyst treatment. Based on the main principle, the methods are classified into three categories, ultrasound-guided percutaneous drainage, surgical drainage and flexible endoscopic drainage. The major classifications and treatment techniques are highlighted for their advantages and disadvantages.Conclusion. There exist no generally adopted strategy for pancreatic pseudocyst treatment in current clinical practice and no evidence on a particular method application in a large patient cohort. The publication survey identifies the techniques of percutaneous, surgical and endoscopic drainage with ultrasound control as highly effective overall among other surgical treatments.

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Pancreatic pseudocyst: Dilemma of its recent management (Review)

Cited by 29 publications

References 53 publications

Treatment of oversize and recurrent pancreatic pseudocyst after an episode of acute pancreatitis: a case report and review management

Treatment of oversize and recurrent pancreatic pseudocyst after an episode of acute pancreatitis: a case report and review management

Current status of treatments of pancreatic and peripancreatic collections of acute pancreatitis

Current treatment of pancreatic pseudocysts: a systematic review

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