Pancreatic pseudocysts: 10 years of experience

BACKGROUND: Pancreatic pseudocysts (PP) are considered to be one of the major complications of acute, chronic, and posttraumatic pancreatitis. Their treatment has always been a surgical challenge. Surgical treatment was for many years the only choice in the management of PP. However, technological development has provided new alternatives in their management. PURPOSE: The purpose of this retrospective study is to present our experience in the treatment of PP and to define the criteria for the selection of the treatment method. METHODS: During the past decade, 14 patients were treated for PP in our clinic. We classified our patients in three groups based on the treatment: A, conservative treatment; B, surgical treatment with internal drainage; and C, percutaneous external drainage (PED) under CT guidance. RESULTS: Conservative treatment had excellent outcome when it was applied in patients with small cysts. Internal drainage was always successful, but patients needed more hospitalization and showed increased morbidity compared to PED. PED was successful in two of three patients. CONCLUSIONS: Conservative treatment is a good choice for small asymptomatic cysts, particularly for patients who are poor candidates for operation. Internal drainage is a good method of treatment and should be used as the first choice by experienced surgeons. Finally, PED is a good first choice for patients with a unilocular cyst and contraindications for surgery.