TREATMENT OF PANCREATIC PSEUDOCYSTS BY EXTERNAL DRAINAGE

  • 1 January 1979
    • journal article
    • research article
    • Vol. 148  (5) , 707-710
Abstract
Patients [22] were treated for 25 occurrences of pancreatic pseudocysts. The male to female ratio was 3:1 and the average age was 39 yr. Alcoholism was the most common cause of the preceding episode of pancreatitis. The pseudocyst rarely developed from end-stage chronic pancreatitis. Preferred treatment for the majority of pancreatic pseudocysts is external sump drainage if there is no obstruction of the distal part of the pancreatic duct. This form of treatment was followed by a 100% survival rate and neither a pancreaticocutaneous fistula nor a pancreatic abscess occurred. The 2 instances of a recurrence were due to treatment with a Penrose drain alone; this practice is not recommended. Obstruction of the distal part of the pancreatic duct negates external sump drainage; in such instances, a Roux-en-Y cystojejunostomy should be the treatment of choice and not transgastric cystogastrostomy, which does not offer dependent drainage. The treatment of a pancreatic pseudocyst should not be equated with that of chronic fibrotic pancreatitis, as the basic pathologic clinical features and response to surgical treatment are quite different.

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