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August 1984

Percutaneous Drainage of Infected Pancreatic Pseudocysts

Author Affiliations

From the Departments of Radiology (Drs Gerzof and Robbins), Surgery (Drs Johnson and Nabseth), and Gastroenterology (Dr Spechler), Boston Veterans Administration Medical Center, Tufts University School of Medicine, and Boston University School of Medicine.

Arch Surg. 1984;119(8):888-893. doi:10.1001/archsurg.1984.01390200008002

• After diagnostic needle aspiration guided by computed tomography and/or ultrasound, 11 infected pseudocysts in ten patients were treated nonoperatively by percutaneous catheter drainage and intravenously administered antibiotics. Nine infected pseudocysts resolved after 11 to 37 days (mean, 21 days) with no recurrences at follow-up 16 to 42 months (mean, 24.4 months) later. All were confirmed by Gram's stain, culture, and elevated amylase levels. Ten of the pseudocysts were acute; one was chronic; five were polymicrobial; six had a single organism. There were no major complications. There was one failure when a pancreatic abscess developed in a patient who died following operative drainage. There was one successful palliation of a postoperative-infected pseudocyst in a patient with an obstructing nonresectable carcinoma of the head of the pancreas. A trial of percutaneous catheter drainage is indicated in patients with infected pancreatic pseudocysts.

(Arch Surg 1984;119:888-893)