• DOI:10.6084/M9.FIGSHARE.1561272.V1
• Corpus ID: 10948586

A clinical study of Pancreatic pseudocyst and its management: An institutional experience

@inproceedings{Wani2015ACS,
  title={A clinical study of Pancreatic pseudocyst and its management: An institutional experience},
  author={Parag Wani and Hussain Ahmed and Kabir Rajkhowa},
  year={2015}
}

• Parag Wani, H. Ahmed, Kabir Rajkhowa
• Published 1 October 2015
• Medicine

Background: Management of pancreatic pseudocysts is associated with considerable morbidity (15– 25%).Traditionally, pancreatic pseudocysts have been drained because of the perceived risks ofcomplications including infection, rupture or haemorrhage. We have adopted a more conservativeapproach with drainage only for uncontrolled pain or gastric outlet obstruction. This study reports our experience. Patients and Methods: A consecutive series of 40 patients with pancreatic pseudocysts were treated over an 1-year period in Gauhati Medical College and Hospital,Guwahati. This study group comprised of 30 men and 10 women with a median age of 35 years (range, 15–75 years). Thirty patients had a preceding attack of acute pancreatitis whilst 10 patients had clinical and radiological evidence of chronic pancreatitis. Results: All patients were initially managed conservatively and intervention, either by Radiological-assisted external drainage or cyst-enteric drainage (by surgery), was only performed for persisting symptoms or complications. Patients treated conservatively had 3 monthly follow-up abdominal ultrasound scans (USS) for 1 year. The aetiology comprised of alcohol (28/40, 70%) gallstones (5/50,12.5%), trauma (4/40, 10%), and idiopathic (3/40, 7.5%).Twenty-five of the 40 patients (62.5%) were successfully managed conservatively, whilst 15 patients required intervention either bypercutaneous radiological drainage (13), by open surgicalcystenteric drainage (2). Themost common indications for invasive intervention in the 15 patients were persistent pain (12), gastric outlet obstruction (2), jaundice (1). Although two patientrequired surgery for gastric outlet obstruction, no other patients required urgent or scheduled surgery forcomplications of untreated pancreatic pseudocysts. Two of the 13 patients treated by percutaneousradiological drainage had recurrence of pancreatic pseudocysts requiring surgery. Conclusions: These results suggest pseudocysts improve spontaneously. A longer period of a ‘‘wait-and-see’’ policy for more than 6 weeks is suggested for asymptomatic pseudocyst, especially for a single lesion.