Pancreatic pseudocysts: the role of percutaneous catheter drainage.

The case records of 69 patients who had pancreatic pseudocysts were reviewed retrospectively. All patients had abdominal pain and tenderness, 38 had nausea and vomiting, 9 had chills and fever and 5 had jaundice. Forty-eight patients had elevated body temperatures and 26 had elevated leukocyte counts. A history of alcoholism was obtained in 48 patients. Ultrasonography demonstrated 54 pseudocysts near the body of the pancreas, 8 near the tail and 7 near the head. Thirty-nine patients had internal drainage, 16 had laparotomy and external drainage and 14 had percutaneous catheter drainage. One of these 14 patients died of uncontrollable sepsis. Six of the 39 patients who had internal drainage had clinical evidence of sepsis (4 had septic complications postoperatively, and 2 died); the remaining 33 patients who had noninfected pseudocysts left hospital within 20 days of operation. However, only four of nine patients who had percutaneous drainage for noninfected pseudocysts left hospital within 20 days of the procedure. Thus, the authors recommend that infected pancreatic pseudocysts be managed by percutaneous catheter drainage and noninfected pseudocysts by internal drainage.