Pancreatic pseudocyst - surgical strategy and management

Abstract

Introduction: Surgical management of patients with pancreatic pseudocyst remains a difficult problem, the causes being obscure pathogenesis, unpredictable evolution, high lethality in cases of development of serious complications, controversies in diagnosis criteria and therapeutic options. Purpose: Evaluation of the results of the strategy and surgical management applied in the treatment of patients with pancreatic pseudocyst (PP). Material and methods: The study presents the results of the surgical treatment applied to 347 patients with pancreatic pseudocyst, carried out during the years 1992-2020 in the Surgery Clinic No.2, IMSP SCR „Timofei Moșneaga” Results: Surgeries performed: cystopancreatojejunostomy (CPJS) on the loop by Roux 215(61,96%) cases, external drainage of PP 10 (2,88%) cases[fig.1], choledocojejunostomy on a speculate loop by Roux 37(10,66%) cases[fig.2], caudal pancreatectomy with pancreaticojejunostomy, splenectomy 5 (1,44%) cases[fig.3], enucleation of pancreatic cyst – 1 (0,29%) case, cephalic duodenopancreatectomy – 2 (0,58%) cases[fig.4]. Conclusions: The severity of clinically assessed pancreatic lesions, laboratory and imaging results versus associated pathologies argues an individual, multidisciplinary approach to the patient with pancreatic pseudocyst.