Pseudocysts in chronic pancreatitis. Surgical results in 102 consecutive patients
T. Kiviluoto, L. Kivisaari, E. Kivilaakso and M. Lempinen
Second Department of Surgery, Helsinki University Central Hospital, Finland.
Preoperative symptoms, diagnoses, and postoperative outcomes in 102
consecutive patients with pancreatic pseudocysts were analyzed. Upper
epigastric pain, loss of weight, obstructive jaundice, and sudden arterial
bleeding from the pseudocyst were the most common preoperative symptoms.
Ultrasonography, computed tomography, and endoscopic retrograde
cholangiopancreatography were the most useful diagnostic tools in the
evaluation of the presence, size, location, and possible pancreatic ductal
communications of the pseudocyst. In a single thick-walled pseudocyst, the
best long-term results were achieved by internal drainage. Pancreatic
resection is justified if the patient already has diabetes or multiple
pseudocysts or if the pseudocyst is not amenable to internal drainage. The
most fatal preoperative complication was a sudden arterial bleeding from a
pseudocyst. In treating this complication, hemostasis with transcystic
arterial ligation and external drainage of the pseudocyst gave the best
results.
