Therapeutical Aspects Regarding Pancreatic Pseudocysts

David, Oana Ilona; Grigorean, Valentin Titus

doi:10.21614/chirurgia.113.3.353

Cited by 3 publications

(2 citation statements)

References 60 publications

(96 reference statements)

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“…Partial pancreatectomy is mostly indicated for extensive chronic pancreatitis in the presence of multiple small pseudocysts in the pancreas, large pseudocysts causing biliary and pancreatic duct obstruction, duodenal infarction, haemorrhage and potentially with severe symptoms [18]. Study showed [30] that the morbidity and mortality rate in patients undergoing open surgery is less than 1%, complication rate is nearly 30% and recurrence rate is 6%. With the popularity of endoscopic cyst drainage, open internal drainage of simple pseudocysts has been gradually replaced by endoscopic drainage, while external drainage has now been largely eliminated by percutaneous transluminal drainage due to the high trauma and complications of indwelling catheters.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Internal Drainage for Pediatric Pancreatic Pseudocysts

Xiong,

Qiu,

et al. 2024

Preprint

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Background: Pancreatic pseudocysts are rare in the pediatric population. Currently, internal drainage surgery is considered the ideal treatment for this disease. However, there have been few reports on laparoscopic pediatric pancreatic pseudocyst jejunal Roux-en-Y anastomosis surgery. Therefore, this study aimed to investigate the efficacy and safety of laparoscopic pancreatic pseudocyst jejunal Roux-en-Y anastomosis surgery in the treatment of pancreatic pseudocysts in children. Methods: A retrospective analysis was conducted on clinical data from three pediatric pancreatic pseudocyst cases admitted to the department of Pediatric Surgery of Sun Yat-sen Memorial Hospital, Sun Yat-sen University from April 2021 to September 2023. All patients were received CT or MR scan to evaluate the location and size of the lesions. The dynamic changes in blood leukocyte analysis, serum amylase, and liver function were also checked before and after surgery. The inclusion criteria for surgical treatment were ineffective drug treatment, a cyst diameter greater than 6 cm, and patients with cysts present for more than 6 weeks. General clinical data, blood test results, surgical time, intraoperative blood loss, and postoperative complications were collected and statistically analyzed. All patients were followed up for 2-12 months, with an average follow-up time of 8.33 months. Results: There were 1 male and 2 female patients, aged between 7 and 14 years with an average age of 9.66 years. All patients had a body mass index (BMI) <15, classified as severely underweight. The diagnosis of pancreatic pseudocysts was made based on clinical manifestations, hematological test results, and CT/MR imaging. Two patients underwent laparoscopic pancreatic pseudocyst jejunal Roux-en-Y anastomosis surgery, while one patient received drug therapy. The intraoperative blood loss for the two surgical patients was 20 ml each, with no blood transfusions required intraoperatively. On the 4th postoperative day, bowel movements resumed, and on the 5th postoperative day, oral intake resumed. The abdominal drainage tube was removed within 1 week postoperatively, and a CT scan performed 1 week after surgery showed a significant reduction in the size of the pancreatic pseudocyst with unobstructed internal drainage. No complications such as fever, bleeding, pancreatic leakage, intestinal leakage, anastomotic stenosis, intestinal obstruction, or fistula formation occurred postoperatively. Blood leukocyte count, serum amylase, and transaminase levels transiently increased on the 1st postoperative day and subsequently decreased to normal levels within 1 week, stabilizing within the normal range. The serum amylase levels gradually decreased to normal in the patient receiving drug therapy, with blood leukocyte count and transaminase levels remaining within the normal range. All patients recovered well, and no recurrence or progression of pancreatic pseudocysts was observed. Conclusion:Laparoscopic pancreatic pseudocyst jejunal Roux-en-Y anastomosis surgery is safe and effective in the treatment of pancreatic pseudocysts in children and deserves to be promoted.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Internal Drainage for Pediatric Pancreatic Pseudocysts

Xiong,

Qiu,

et al. 2024

Preprint

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“…The current consensus indicates that only approximately 30% of PCLs are pseudocysts. This change in tendency results primarily from the development of EUS-FNA and its increased use [ 24 , 25 , 26 ]. Pseudocysts contain fluid collection surrounded by a wall of fibrous tissue without epithelium lining and are connected with the pancreatic duct system, either as a direct communication or indirectly through the pancreatic parenchyma.…”

Section: Types Of Incidental Pancreatic Lesionsmentioning

confidence: 99%

Pancreatic Incidentaloma

Caban

Małecka-Wojciesko

2022

JCM

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Pancreatic incidentalomas (PIs) represent a clinical entity increasingly recognized due to advances in and easier access to imaging techniques. By definition, PIs should be detected during abdominal imaging performed for indications other than a pancreatic disease. They range from small cysts to invasive cancer. The incidental diagnosis of pancreatic cancer can contribute to early diagnosis and treatment. On the other hand, inadequate management of PIs may result in overtreatment and unneeded morbidity. Therefore, there is a strong need to evaluate the nature and clinical features of individual PIs. In this review, we summarize the major characteristics related to PIs and present suggestions for their management.

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Diagnostics and Management of Pancreatic Cystic Lesions—New Techniques and Guidelines

Rogowska,

Semeradt,

Durko

et al. 2024

JCM

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Pancreatic cystic lesions (PCLs) are increasingly diagnosed owing to the wide use of cross-sectional imaging techniques. Accurate identification of PCL categories is critical for determining the indications for surgical intervention or surveillance. The classification and management of PCLs rely on a comprehensive and interdisciplinary evaluation, integrating clinical data, imaging findings, and cyst fluid markers. EUS (endoscopic ultrasound) has become the widely used diagnostic tool for the differentiation of pancreatic cystic lesions, offering detailed evaluation of even small pancreatic lesions with high sensitivity and specificity. Additionally, endoscopic ultrasound–fine-needle aspiration enhances diagnostic capabilities through cytological analysis and the assessment of fluid viscosity, tumor glycoprotein concentration, amylase levels, and molecular scrutiny. These detailed insights play a pivotal role in improving the clinical prognosis and management of pancreatic neoplasms. This review will focus mainly on the latest recommendations for the differentiation, management, and treatment of pancreatic cystic lesions, highlighting their clinical significance.

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Therapeutical Aspects Regarding Pancreatic Pseudocysts

Cited by 3 publications

References 60 publications

Laparoscopic Internal Drainage for Pediatric Pancreatic Pseudocysts

Laparoscopic Internal Drainage for Pediatric Pancreatic Pseudocysts

Pancreatic Incidentaloma

Diagnostics and Management of Pancreatic Cystic Lesions—New Techniques and Guidelines

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