IS THERE STILL A PLACE FOR SURGERY IN THE TREATMENT OF COMMUNICATING PSEUDOCYSTS OF CHRONIC-PANCREATITIS

The purpose of this study was to evaluate the results of long term per cutaneous catheter drainage in the treatment of chronic pancreatic pse udocysts communicating with pancreatic ducts. Since 1986, 13 consecuti ve patients with symptomatic pseudocysts were treated prospectively. A ll pseudocysts were associated with chronic pancreatitis. The location was head (n = 8), body (n = 3) or tail (n = 2). The procedure include d fine needle aspiration under ultrasonic control, percutaneous draina ge along a guide wire and closed suction aspiration. A radiological co ntrol was performed weekly and the catheter was left in place until to tal resolution of pseudocyst. Immediate relief of pain and resolution of pseudocyst were obtained in all 13 patients. The average length of hospital stay was 12.2 +/- 8 days (1 to 23). The average duration of d rainage was 36 days. There was no mortality of morbidity related to th e drainage. There were two asymptomatic recurrences, but long-term fol low-up (mean 3 years) showed that all 13 patients were symptom-free. T he clinical results of such a long-term catheter drainage seem better in our study than in other previous series. It is a simple and innocuo us procedure, and could be carried out in an outpatient unit. Such dra inage represents an efficient alternative to endoscopic or surgical tr eatment of chronic pancreatic pseudocyst with ductal communication. In our experience surgery is no longer indicated.