Pancreatic pseudocyst is a rare disease, in general surgical practice. It is the result of fluid accumulation, which becomes localiz and makes a fibrous wall resulting from secondary inflammation without epithelial lining, in or about the
pancreas
from
disrupiton of major duct, either by trauma or as a consequence of acute or chronic pancreatitis.
Recently, in the diagnosis of pseudosyst, ultrasound examination of the abdomen, ERCP and computed tomographic scanning have been the most reliable diagnostic test.
There is widespread agreement that unless it resolves within 6 weeks, surgical treatment is indicated. The 58 cases reviewed were treated surgically between Jan. 1972 and Jan. 1991 at Pusan National University Hospital.
The finding are summarized briefly as followes:
1) Age and Sex distribution of these patients showed that 25 cases occured between 2nd and 3rd decades. The male to female ration was 2.6 : 1.
2) The etiology of pseudocyst; Pancreatitis was cause in 39.6% and unknown eitology, trauma, biliary tract disease were other main causes in that order.
3) Clinical manifestation; Abdominal pain was the most common symptom(81.9%) and abdominal tenderness(82.8%), abdominal mass(58.6%) occured in orders.
4) Comparative accuracy of dignostic methods; Abdominal CT and ERCP was 100%, Ultrasonogram showed 78.6%, UGI showed 72.9% in its diagnostic accuracy.
5) Location of pseudocyst; Pancreatic pseudocysts were most commonly found in the body of pancreas(53.4%), in tail(22.4%).
6) The size of pancreatic pseudocyst, Less than 5 cm(10.3%), above 11 cm(36.3%), 6~10cm in diameter(53.4%) as estimate in 58 cases.
7) Findings on culture(done in 26 out of 58 cases); Positive bacterial growth in 9 cases(34.4%),3 E.Coli, 3 staphylococcus, 1 streptococcus, 1 Klebsiella, 1 serratia.
8) Surgical treatment; Among 58 cases, resection was done in 4 cases and drainage procedure was in 54 cases. External drainage was performed in 6 cases, internal drainage in 48 cases which revealed that cystogastrostomy (14),
cystoduodenostomy(6),
cystojenunostomy(28). Reoperation was performed in 4 cases due to recurrent or persistent pancreatic pseudocyst.
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