Surgical treatment for huge pancreatic pseudocysts

Quanfang Liu; Yuan Yao; Zhidu Wang; Chiming Huang; Zeyu WU; Jinrui OU

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Surgical treatment for huge pancreatic pseudocysts

VernacularTitle:胰腺巨大假性囊肿27例的外科治疗
Author: Quanfang LIU ; Yuan YAO ; Zhidu WANG ; Chiming HUANG ; Zeyu WU ; Jinrui OU
Publication Type:Journal Article
Keywords: Pancreatic cyst; Anastomosis,Roux-en-Y; Drainage
From: Chinese Journal of General Surgery 2009;24(3):189-192
CountryChina
Language:Chinese
Abstract: Objective To explore the clinical characteristics of huge pancreatic pseudocysts and to evaluate the effect of different surgical treatments. Method We retrospectively analyzed the clinical data of 27 patients with huge pancreatic pseudocyst managed from Feb 1991 to Feb 2008. Result Among a total of 129 patients with pancreatic pseudocyst treated during this period of time,27 (20.9% ) patients were diagnosed as with huge pancreatic pseudocyst (diameter > 10cm). As to the etiology, 51.9% of the psudoeyst was caused by acute pancreatitis, 33.3% by pancreatic trauma and previous surgery, 11.1% by chronic pancreatitis. Pseudoeysts in the majority of cases(21/27)had a history less than 6 weeks. Upper GI obstruction complicated 30% cases (8/27). Imaging showed that all huge pancreatic pseudocysts were single. ERCP showed communication with the main pancreatic duct in 9 out of 11 cases. Nine cases underwent catheter drainage, 10 cases underwent cystogastrostomy,2 cases underwent endoscopic drainage of pancreatic pseudocyst via ERCP, 17 cases underwent Roux-en-Y cystojejunostomy including 11 cases in which other previous procedures failed. All 27 cases were finally cured. Conclusions Huge pancreatic pseudocyst might have unique clinical characteristics. Anatomical changes of main pancreatic duct were found in most cases under ERCP. The proper time and indication for surgical intervention might be different from minor pancreatic pseudocyst.