Delattre J F, Flament J B, Avisse C, Dron B, Concé J P
Service de Chirurgie générale et digestive, C.H.U. Reims.
Chirurgie. 1996;121(1):57-65.
25 to 35% of the patients with calculous chronic pancreatitis will develop a pseudocyst in the course of their disease. Up to recent years pancreatic pseudocysts were treated surgically most of the time by internal drainage (cysto jejunostomy). More recently, it was proved that percutaneous drainage could collapse pseudocysts if aspiration was maintained within 3 to 4 weeks. From January 1986 to December 1994, 22 patients with Wirsung communicating pseudocysts were treated percutaneously. Total recovery was achieved in 11 patients (50%). In these cases the pancreatic out flow towards the duodenum was always restored. There were 8 recurrences, always in relation with persistent or recurrent obstruction of the pancreatic main duct. Modern procedures, associating extra corporal lithotripsy and transpapillary endoscopic management should allow to reduce the failure rate of percutaneous drainage. According to their results, the authors state that an unuseful operation can be avoided in 50% of the patients with percutaneous drainage only. This success rate could probably be increased with association of other non invasive procedures aiming at the permeability of pancreatic duct.
