Pancreatic Pseudocysts - Proposal for Diagnosis and Surgical Management -

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To determine the clinical features and problems presented by a pancreatic pseudocyst, eighteen patients managed at our hospitals since 1980 were reviewed. Males predominated with a ratio of 16: 2, and the average age was 36.2 years. Pseudocyst was located in the pancreatic head in 6, in the body in 6, in the tail in 5 and multiple pseudocysts in one case. The cause of pancreatic pseudocyst was chronic pancreatitis in 9 (including 8 patients with histories of alcoholism), acute pancreatitis in 2 and trauma in 7 patients, respectively. Three patients were associated with pancreatic calculi. Rupture of pseudocyst occurred in one patient with multiple cysts. Autopsy showed acute pancreatic necrosis and penetration to the stomach and duodenum. The indications for surgery were principally cyst-related symptoms(infection, hemorrhage, enlargement and compression of adjacent organs) and differential diagnosis from malignancy. Most of the patients underwent internal drainage ; 9 cystojejunostomy, 2 cystogastrostomy). Three patients underwent cystojejunostomy with longitudinal pancreaticojejunostomy for chronic pancreatitis. Massive hemorrhage after cystogastrostomy occurred in one patient with infected pseudocysts, which required removal of the cysts. Postoperative outcome of the 17 surgical patients was excellent in 16 patients. Only one patient died of pancreatitis associated with alcohol abuse, resulting in a 5.9% mortality. This study suggests that adequate internal drainage by pancreaticojejunostomy to treat the underlying pancreatic disease is most important to obtain an excellent prognosis in patients with pseudocysts.
長崎大学の論文

Pancreatic Pseudocysts - Proposal for Diagnosis and Surgical Management -

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