Simultaneous treatment of chronic pancreatitis and pancreatic pseudocyst
J. S. Munn, G. V. Aranha, H. B. Greenlee and R. A. Prinz
Records from 87 consecutive patients undergoing lateral
pancreaticojejunostomy (LPJ) for chronic pancreatitis were reviewed to
determine the incidence of pseudocyst and the safety of combined pancreatic
duct and pseudocyst drainage. Twelve patients had undergone previous
pancreatic pseudocyst drainage; four of them also had pancreatic
pseudocysts present at the time of LPJ. In addition, 22 patients had
pseudocysts identified preoperatively and/or confirmed at operation. The
overall incidence of pseudocyst was 39%. Twenty-six patients (group 1)
underwent pancreaticojejunostomy combined with pseudocyst drainage.
Sixty-one patients (group 2) underwent pancreaticojejunostomy only.
Operative morbidity and mortality results (19% and 8%, respectively, in
group 1; 18% and 2%, respectively, in group 2) were similar. Patient
outcome was also similar in the two groups (81% and 84% of patients
obtained pain relief in groups 1 and 2, respectively). There were no
pseudocyst recurrences in either group. Thus, there is a high incidence
(39%) of pancreatic pseudocyst in patients undergoing LPJ for chronic
pancreatitis. Combined drainage of the pancreatic duct and pseudocyst is
safe and effective.
