Unresolved Problems of Pancreatic Pseudocysts

Abstract

The treatment of 54 patients with pancreatic pseudocysts was reviewed. The operative mortality was 11% and after an average followup of 3 years the recurrence rate was 3.8%. Hemorrhage was the most significant complication of pseudocysts and occurred in 4 patients preoperatively and three patients postoperatively. The patients who developed recurrence or died had been operated within one day after the diagnoses of pseudocysts were made. The deaths were due to the conditions that necessitated the emergency operations rather than to the fact that the cyst wall had not adequately matured. Ideally, operation should be performed when the patient has reached an optimal clinical condition and the walls of the cyst are sufficiently thick. Currently there is no guide for estimation of the state of cyst maturation, although this may develop with the use of ultrasound. Since complications can develop during a prolonged observation period it was our policy to proceed with surgery as soon after diagnosis as the patient was in satisfactory clinical condition. It is evident from this study that internal drainage can be performed safely in less time than the 6 weeks frequently recommended. Morbidity and mortality were not adversely affected by a short interval between diagnosis and operation if the timing was a matter of election rather than a condition of emergency.

A Rare Case of Severe Acute Pancreatitis Complicated with Pancreatic Pseudocysts, Obstructive Jaundice and Intraperitoneal Hemorrhage.

“…Furthermore, rupture of the pancreatic pseudocyst caused by an intracystic hemorrhageis also reported to be an extremely rare phenomenon ( 14,19,20). Indeed, in Japan, there have been only 1 1 cases overthe past 15 years to the best of our knowledge (Table 2) (21-31).…”

Complications in Chronic Pancreatitis

“…Pancreatic pseudocysts arc the most common compli cation of chronic pancreatitis with incidence rates ranging from 40 to 60% [71,72], Ninety percent of the patients suffer from persistent abdominal pain, vomiting and weight loss [73] and in even' second patient a palpable mass is present [74],…”

Novel endoscopic management for pancreatic pseudocyst with fistula to the common bile duct

“…It affects more frequently males, most common etiology is alcoholic chronic pancreatitis and abdominal pain is the main clinical presentation. To the best of our knowledge, there have been 17 cases reported in the literature [10][11][12][13][14][15][16][17][18][19][20][21][22][23] , only three of which managed endoscopically [21][22][23] . We present a case of this rare condition successfully resolved performing a simultaneous, independent drainage of the PPs and the CBD, never reported in literature.…”