ENDOSCOPIC RETROGRADE PANCREATOGRAPHY IN THE SURGERY OF PANCREATIC PSEUDOCYSTS

  • 1 January 1979
    • journal article
    • research article
    • Vol. 86  (4) , 639-647
Abstract
Endoscopic retrograde pancreatography (ERP) was performed on 83 patients with 99 pancreatic pseudocysts (PCP). ERP was successful in 76 patients; PCP were found at operation in the other 7. Five characteristic ductal patterns are described and illustrated. The PCP were situated in the head (51 patients), body (21 patients) and tail (20 patients). Thirteen PCP were less than 2 cm, 50 were between 2 and 5 cm and 29 were > 5 cm. There were multiple PCP in 13.2% of patients. ERP was a more accurate diagnostic measure than ultrasonography or upper gastrointestinal roentgenograms, revealing the lesion in 89% of patients. Eight patients with pancreatic ascites had the causative PCP demonstrated prior to operation. Three patients had pancreatic pleural effusions; 2 with effusions on the right had PCP of the tail. Five patients had spontaneous connections between a PCP and the stomach (4 patients) or duodenum (1 patient). Rational surgical planning for the management of PCP is greatly facilitated by preliminary reconnaisance by ERP.