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September 1965

Internal Drainage of Pseudocysts of the Pancreas

Author Affiliations

From the Mayo Clinic and Mayo Foundation. Fellow in Surgery, Mayo Foundation (Dr. Parshall) and Section of Surgery (Dr. Remine).

Arch Surg. 1965;91(3):480-484. doi:10.1001/archsurg.1965.01320150110020

THE TREATMENT of pancreatic pseudocysts has undergone considerable evolution since the first attempts at surgical treatment by Le Dentu19 in 1862 (aspiration) and by Lücke and Klebs20 in 1866 (external drainage), both of which ended fatally. Bozeman1 successfully removed a cyst weighing 20½ lb from the tail of the pancreas without ligating a blood vessel in 1882, a remarkable feat even now. Excision is no longer the treatment of choice. The inflammatory nature, lack of a true capsule, adherence to vital structures, and frequent location of the pseudocyst in the head of the pancreas preclude successful excision most of the time. Meyer and associates23 and Murphy and Hinkamp26 reported a total of 66 cases of pseudocysts; in five of these, treatment was by excision. In a review of the literature between 1945 and 1958, Warren and co-workers38 found 48 cases (10%) in which excision

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