Pancreatic Pseudocysts in Chronic Pancreatitis. Surgical or Interventional Drainage?

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D. BOERMA, H. OBERTOP, D.J. GOUMA

Ann. Ital. Chir., LXXI, 1, 2000

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Pseudocyst formation is a well-known complication of acute and chronic pancreatitis. Many pseudocysts are asymptomatic and may resolve without intervention. For a symptomatic pseudocyst drainage is indicated. Although surgical cystoenterostomy has been the treatment of choice for many years, recently invasive but non-operative treatment methods have challenged surgical drainage as the standard therapy for pancreatic pseudocysts. Both the method as well as the timing of intervention has become a matter of debate. Percutaneous catheter drainage and endoscopic drainage have proven beneficial in the treatment of pseudocysts, although long-term outcome remains to be awaited. Resolution rates after surgical and non-surgical methods are comparable, but clinical and technical aspects may mandate either method. Each patient requires an individual, multidisciplinary approach, thereby obtaining optimal treatment-outcome.