May 1982

Evaluation of Therapeutic Options for Pancreatic Pseudocysts

Author Affiliations

From the Department of Surgery, Loyola University Stritch School of Medicine, Maywood, Ill (Drs Aranha, Prinz, Freeark, and Greenlee), and the Medical (Dr Kruss) and Surgical (Drs Aranha, Prinz, and Greenlee) Services, Hines (Ill) Veterans Administration Hospital.

Arch Surg. 1982;117(5):717-721. doi:10.1001/archsurg.1982.01380290163029

• A review of 81 patients with pancreatic pseudocyst was conducted to assess the value of different treatment modalities. Resection was associated with 18% mortality (two of 11 patients) and 36% morbidity. In three of nine patients undergoing external drainage a recurrent pseudocyst developed, and in one additional patient, a pancreatic fistula persisted. Internal drainage by cystogastrostomy (21 patients) resulted in 9.5% mortality and 9.5% morbidity, whereas cystojejunostomy (33 patients) was associated with a 6% mortality and 6% morbidity. Endoscopic drainage through the posterior wall of the stomach was unsuccessful in the two patients in which it was used. Internal drainage into the stomach, duodenum, or jejunum is a safe and effective approach for most pseudocysts. Persistent symptoms following surgical treatment were primarily related to failure to recognize multiple cysts and/or pancreatic duct obstruction and dilation characteristic of chronic pancreatitis.

(Arch Surg 1982;117:717-721)