Surgical management of pancreatic pseudocyst: a single-center experience

Shehta, Ahmed; Elghawalby, Ahmed N.; Fouad, Amgad; Elshobary, Mohamed; Abulazm, Ibrahem L.; Kassem, Amr; Farouk, Ahmed; Elrefai, Mohamed; El Sorogy, Mohamed

doi:10.4103/ejs.ejs_169_20

Surgical management of pancreatic pseudocyst: a single-center experience

Authors

Abstract

Aim
Pancreatic pseudocyst is the commonest cystic lesion of the pancreas. It usually develops on a background of pancreatitis. Cyst recurrence is the most feared complication following surgical management of pancreatic pseudocyst.
Patients and methods
The authors reviewed the data of 48 patients who were managed surgically during the period between 2010 and 2019.
Results
Biliary pancreatitis was the commonest cause (24 cases − 50%). The mean cyst size was 13.5±6.4 cm (6–42 cm). Most lesions were located in the body and tail of the pancreas (32 cases − 66.7%). Open approach was performed in 45 (93.8%) cases whereas the remaining cases were performed laparoscopically. Cases were managed by cystogastrostomy (39 cases − 81.3%), cyst-jejunostomy (seven cases − 14.6%), combined procedures (one case − 2.1%), or central pancreatectomy (one case − 2.1%). Cholecystectomy was performed in 17 (35.4%) cases. Early postoperative morbidity was encountered in nine (18.8%) cases. After a median follow-up of 68 months, no recurrence was detected. One (2.1%) case developed incisional hernia, and another one (2.1%) had adhesive intestinal obstruction.
Conclusion
Surgical intervention for pancreatic pseudocysts is a safe and feasible approach. It offers the ability to deal with the primary cause during operation and excellent long-term outcome regarding pseudocyst recurrence.

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