DRAINAGE OF CYSTS ASSOCIATED WITH CHRONIC-PANCREATITIS UNDER SONOGRAPHIC GUIDANCE

Since 1975, it has become possible to drain cysts associated with chro nic pancreatitis percutaneously under sonographic guidance. Thirty-sev en cysts in 35 patients have been punctured by this method. After a 23 -month follow-up, 24% of the patients were considered completely heale d while 35% did not present with pain again. Failure of the treatment was observed in 41% of the patients (relapse ranging from 2 days to 10 months). We observed no mortality and a 14% morbidity rate. Repetitio n of puncture did improve the clinical result; this latter cannot be p redicted by the existence or not of a communication with the ductal sy stem. Large cysts located in the head of the pancreas and hemorrhagic cysts relapsed systematically and must be considered a contraindicatio n for this treatment. By contrast, primary or secondary infection of t he cystic content did not appear to be predictive failure factors. Thi s method should be used, in a first approach, for small cysts in the h ead of the pancreas or for cysts in the body of the tail that do not b ulge into the digestive tract.