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Diagnosis and treatment of complicated postnecrotic cysts of pancreas
Authors:Gostishchev V K  Afanas'ev A N  Ustimenko A V
Abstract:Experience of complex treatment of 137 patients with complicated postnecrotic pancreatic cysts (PPC) is analyzed. Indications to different surgical methods are formulated differentially depending on complications of cysts, localization, sizes, "maturity" of cyst walls, communication with main pancreatic duct. Treatment of festered PPC should be started with minimally-invasive methods; at negative result the omentobursocystostomy with staged endoscopic sanations should be done that permits to decrease the number of postoperative complications and to reduce lethality from 14.3 to 4.5%. Resection of pancreas along with cyst is the operation of choice at pancreatic cysts complicated with bleeding; lethality has been reduced from 28.6 to 5.6%. Perforation of cysts into abdominal cavity is the indication to omentobursocystostomy with staged sanations of omental bursa, perforation into pleural cavity -- to distal resection of pancreas.
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