A Clinical Analysis of Pancreatic Pseudocysts

ABSTRACT

A pancreatic pseudocyst is a fluid-filled cystic structure without a true epithelial lining that is associated with the pancreas or pancreatic duct. Its walls are composed of fibrous and granulation tissue. Pancreatic pseudocysts occur in 2~10% of patients with pancreatic disease. The most common cause of a pancreatic pseudocyst is an alcoholic pancreatitis. Treatment of a pancreatic pseudocyst is composed of conservative and surgical treatment. The objective of this study was to improve the prognosis for patients with a pancreatic pseudocyst by suggesting the most appropriate treatment method and the timing for the treatment. The clinical courses of 57 patients with pancreatic pseudocysts who were treated at the Department of Surgery, College of Medicine, Chung Ang University from January 1975 to December 1995 were retrospectively reviewed. The sex and the age distributions, the etiology, the clinical manifestations, the diagnostic methods, and the treatments and their results were analyzed. The result are as follows: The sex ratio of males to females was 1.7 : 1. The most prevalent age groups were the third and the fourth decades. The most common cause of pancreatic pseudocysts was alcoholic pancreatitis. The frequent symptoms were abdominal pain and an abdominal mass. The most valuable diagnostic tests were ultrasonography and abdominal computerized tomography. The locations of the pancreatic pseudocysts were the tail, the body, and the head in order of frequency. The applied surgical methods were internal drainage, external drainage, and resection. The mortality rate was 5.3%. The mortality and the morbidity rates were different according to the treatment method and the timing of the treatment. Based on these results, it is undesirable that surgical treatment be delayed to expect maturation of cystic wall. The most appropriate timing for surgical treatment is a stable state after inflammation has subsided.