Pancreatic pseudocyst

Recommendations for operative and nonoperative management

K. J. Williams, T. C. Fabian

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

From 1983 to 1990, 76 patients with pancreatic pseudocyst (PP) were managed. Computed tomographic scan (CT) was the primary diagnostic tool (88%). Ethanol accounted for 71 per cent and biliary disease 6 per cent of the occurance of PP. Thirty-eight patients required surgery and 37 were managed nonoperatively. Forty-four PP complications occurred in 29 patients (4 bleeding, 1 ruptured, 13 gastric outlet obstruction, 10 infected, 6 hyperbilirubinemia, 5 pancreatic ascites, 5 pulmonary insufficiency) at a range of 1 day to 5 weeks from diagnosis; all but one occurred during initial hospitalization. Indications for surgery included complications, nonresolution or persistence of symptoms, and expansion. Internal drainage was accomplished in 40 per cent, (half within 4 weeks of diagnosis), 40 per cent underwent distal resection, and 15 per cent external drainage. There were two deaths in the series. Chronic pancreatitis, gallstone etiology, and gastric outlet obstruction significantly correlated with surgical management of the PP. Endoscopic retrograde cholangiopancreatography (ERCP) was helpful in planning the surgical procedure; 70 per cent of those undergoing ERCP had their operative plan altered. Percutaneous drainage failed in six of eight cases. The authors conclude that nonoperative management is safe and effective in 50 per cent of PP patients, if close radiographic follow-up is maintained until resolution.

Original languageEnglish (US)
Pages (from-to)199-205
Number of pages7
JournalAmerican Surgeon
Volume58
Issue number3
StatePublished - Jan 1 1992

Fingerprint

Pancreatic Pseudocyst
Gastric Outlet Obstruction
Drainage
Endoscopic Retrograde Cholangiopancreatography
Hyperbilirubinemia
Chronic Pancreatitis
Gallstones
Ascites
Hospitalization
Ethanol
Hemorrhage
Lung

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Pancreatic pseudocyst : Recommendations for operative and nonoperative management. / Williams, K. J.; Fabian, T. C.

In: American Surgeon, Vol. 58, No. 3, 01.01.1992, p. 199-205.

Research output: Contribution to journalArticle

Williams, KJ & Fabian, TC 1992, 'Pancreatic pseudocyst: Recommendations for operative and nonoperative management', American Surgeon, vol. 58, no. 3, pp. 199-205.
Williams, K. J. ; Fabian, T. C. / Pancreatic pseudocyst : Recommendations for operative and nonoperative management. In: American Surgeon. 1992 ; Vol. 58, No. 3. pp. 199-205.
@article{46b373a28b644378bd8c30b149e156a0,
title = "Pancreatic pseudocyst: Recommendations for operative and nonoperative management",
abstract = "From 1983 to 1990, 76 patients with pancreatic pseudocyst (PP) were managed. Computed tomographic scan (CT) was the primary diagnostic tool (88{\%}). Ethanol accounted for 71 per cent and biliary disease 6 per cent of the occurance of PP. Thirty-eight patients required surgery and 37 were managed nonoperatively. Forty-four PP complications occurred in 29 patients (4 bleeding, 1 ruptured, 13 gastric outlet obstruction, 10 infected, 6 hyperbilirubinemia, 5 pancreatic ascites, 5 pulmonary insufficiency) at a range of 1 day to 5 weeks from diagnosis; all but one occurred during initial hospitalization. Indications for surgery included complications, nonresolution or persistence of symptoms, and expansion. Internal drainage was accomplished in 40 per cent, (half within 4 weeks of diagnosis), 40 per cent underwent distal resection, and 15 per cent external drainage. There were two deaths in the series. Chronic pancreatitis, gallstone etiology, and gastric outlet obstruction significantly correlated with surgical management of the PP. Endoscopic retrograde cholangiopancreatography (ERCP) was helpful in planning the surgical procedure; 70 per cent of those undergoing ERCP had their operative plan altered. Percutaneous drainage failed in six of eight cases. The authors conclude that nonoperative management is safe and effective in 50 per cent of PP patients, if close radiographic follow-up is maintained until resolution.",
author = "Williams, {K. J.} and Fabian, {T. C.}",
year = "1992",
month = "1",
day = "1",
language = "English (US)",
volume = "58",
pages = "199--205",
journal = "American Surgeon",
issn = "0003-1348",
publisher = "Southeastern Surgical Congress",
number = "3",

}

TY - JOUR

T1 - Pancreatic pseudocyst

T2 - Recommendations for operative and nonoperative management

AU - Williams, K. J.

AU - Fabian, T. C.

PY - 1992/1/1

Y1 - 1992/1/1

N2 - From 1983 to 1990, 76 patients with pancreatic pseudocyst (PP) were managed. Computed tomographic scan (CT) was the primary diagnostic tool (88%). Ethanol accounted for 71 per cent and biliary disease 6 per cent of the occurance of PP. Thirty-eight patients required surgery and 37 were managed nonoperatively. Forty-four PP complications occurred in 29 patients (4 bleeding, 1 ruptured, 13 gastric outlet obstruction, 10 infected, 6 hyperbilirubinemia, 5 pancreatic ascites, 5 pulmonary insufficiency) at a range of 1 day to 5 weeks from diagnosis; all but one occurred during initial hospitalization. Indications for surgery included complications, nonresolution or persistence of symptoms, and expansion. Internal drainage was accomplished in 40 per cent, (half within 4 weeks of diagnosis), 40 per cent underwent distal resection, and 15 per cent external drainage. There were two deaths in the series. Chronic pancreatitis, gallstone etiology, and gastric outlet obstruction significantly correlated with surgical management of the PP. Endoscopic retrograde cholangiopancreatography (ERCP) was helpful in planning the surgical procedure; 70 per cent of those undergoing ERCP had their operative plan altered. Percutaneous drainage failed in six of eight cases. The authors conclude that nonoperative management is safe and effective in 50 per cent of PP patients, if close radiographic follow-up is maintained until resolution.

AB - From 1983 to 1990, 76 patients with pancreatic pseudocyst (PP) were managed. Computed tomographic scan (CT) was the primary diagnostic tool (88%). Ethanol accounted for 71 per cent and biliary disease 6 per cent of the occurance of PP. Thirty-eight patients required surgery and 37 were managed nonoperatively. Forty-four PP complications occurred in 29 patients (4 bleeding, 1 ruptured, 13 gastric outlet obstruction, 10 infected, 6 hyperbilirubinemia, 5 pancreatic ascites, 5 pulmonary insufficiency) at a range of 1 day to 5 weeks from diagnosis; all but one occurred during initial hospitalization. Indications for surgery included complications, nonresolution or persistence of symptoms, and expansion. Internal drainage was accomplished in 40 per cent, (half within 4 weeks of diagnosis), 40 per cent underwent distal resection, and 15 per cent external drainage. There were two deaths in the series. Chronic pancreatitis, gallstone etiology, and gastric outlet obstruction significantly correlated with surgical management of the PP. Endoscopic retrograde cholangiopancreatography (ERCP) was helpful in planning the surgical procedure; 70 per cent of those undergoing ERCP had their operative plan altered. Percutaneous drainage failed in six of eight cases. The authors conclude that nonoperative management is safe and effective in 50 per cent of PP patients, if close radiographic follow-up is maintained until resolution.

UR - http://www.scopus.com/inward/record.url?scp=0026560343&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026560343&partnerID=8YFLogxK

M3 - Article

VL - 58

SP - 199

EP - 205

JO - American Surgeon

JF - American Surgeon

SN - 0003-1348

IS - 3

ER -