This paper is only available as a PDF. To read, Please Download here.
Abstract
Background. Computed tomography and endoscopic drainage are used increasingly to treat pancreatic
pseudocysts (PP). We reviewed our experience with PP to compare the outcomes of patients
operated on initially (group 1) with those whose nonoperative treatment failed (computed
tomography-guided or endoscopic drainage) before operation (group 2).
Methods. The records of 70 consecutive patients operated on for PP were reviewed. The 52 patients
(74%) in group 1 and 18 (26%) in group 2 were compared in terms of clinical features,
laboratory lest results on examination and before operation, operative findings, morbidity,
mortality, and recurrence rates.
Results. Before the initial drainage attempt, mean serum amylase level was higher in group
2 (542 ± 25 vs 163 ± 17 IU/L; p = 0.01). All other laboratory values were similar.
Before operative drainage, group 2 patients had lower hemoglobin (10.7 ± 0.5 vs 12.2
± 0.3 gm/dl; p < 0.05) and serum albumin level (2.7 ± 0.2 vs 3.5 ±0.1 mg/dl; p < 0.01)
than group 1. Morbidity was twice as frequent in group 2 (33% vs 14%). The time from
initial attempt at drainage to PP resolution was longer in group 2 (104 ± 36 vs 20
± 4 days; p = 0.01). However, the time from operation to resolution was similar in
both groups (21 ± 8 vs 20 + 4 days).
Conclusions. Failed nonoperative drainage is associated with a protracted illness and carries
a risk of increased morbidity after operative intervention.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Twenty-five year experience with pancreatic pseudocysts: are we making progress.Am J Surg. 1985; 149: 705-708
- The nature and course of cystic pancreatic lesions diagnosed by ultrasound.Arch Surg. 1983; 118: 486-488
- Timing of surgical drainage for pancreatic pseudocyst.Ann Surg. 1985; 202: 720-724
- Pseudocysts in chronic pancreatitis: surgical results in 102 consecutive patients.Arch Surg. 1989; 124: 240-243
- Presentation of pancreatic pseudocysts: implications for timing of surgical intervention.Am J Surg. 1986; 151: 749-775
- Don't fix nothin' that ain't broke [Editorial].Am J Surg. 1985; 149: 197
- Percutaneous aspiration and drainage of pancreatic pseudocysts.AJR. 1986; 147: 1007-1009
- Percutaneous puncture and drainage of pancreatic pseudocysts: a retrospective study.Acta Radiol. 1990; 31: 177-180
- Long term results of percutaneous catheter drainage of pancreatic pseudocysts.Surg Gynecol Obstet. 1992; 175: 293-298
- Percutaneous catheter drainage of pancreatic pseudocysts.Am Surg. 1991; 57: 29-33
- Percutaneous drainage of infected and noninfected pancreatic pseudocysts: experience in 101 cases.Radiology. 1989; 170: 757-761
- Endoscopic transpapillary therapy for disrupted pancreatic duct and peripancreatic fluid collections.Gastroenterology. 1991; 100: 1362-1370
- Endoscopic management of cysts and pseudocysts in chronic pancreatitis: long term follow up after 7 years of experience.Gastrointest Endosc. 1989; 35: 1-9
- Endoscopic drainage of pancreatic pseudocysts.Gastrointest Endosc. 1985; 31: 322-328
- Percutaneous catheter drainage compared with internal drainage in the management of pancreatic pseudocyst.Ann Surg. 1992; 215: 571-578
- Preoperative endoscopic retrograde cholangiopancreatography in patients with pancreatic pseudocyst associated with resolving acute and chronic pancreatitis.Ann Surg. 1989; 209: 532-540
- Simultaneous treatment of chronic pancreatitis and pancreatic pseudocyst.Arch Surg. 1987; 122: 662-667
Article info
Footnotes
☆Presented at the Fiftieth Annual Meeting of the Central Surgical Association, Cincinnati, Ohio, March 4–6, 1993.
Identification
Copyright
© 1993 Published by Elsevier Inc.
