Endoscopic drainage of the pancreatic pseudocyst

Background. Pancreatic pseudocyst is a common complication of chronic pancr eatitis occurring in 20% to 40% of cases. Pseudocysts can be treated try en doscopic cystenterostomy or transpapillary drainage, percutaneously with co mputed tomography guidance or operatively. Methods. A total of 36 endoscopic pancreatic pseudocyst drainage procedures were performed in 29 patients with 34 pseudocysts. Eighty percent presente d with chronic pain, 25% had recurrent pancreatitis and approximately one h alf of the patients had either gastric outlet obstruction or abdominal mass . Results. Thirty-six endoscopic drainage procedures were performed, 27 cyste nterostomies and 9 transpapillary drainages. Endoscopic treatment achieved complete resolution of the pseudocyst in 24 of 29 patients (83%), and the o ther 5 (17%) eventually required surgery. Two patients required distal panc reatectomy because of their pancreatic pathology, 2 cystgastrostomies for p ersistence of the pseudocyst, and 1 external drainage of an infected pancre atic cyst. The mean follow-up after the initial drainage was 16 months. The re were no deaths attributed to the procedures and no complication that req uired surgery. Only 1 nonadherent pseudocyst (cystadenoma) required immedia te operation after attempted, endoscopic drainage. Conclusion. We conclude that endoscopic drainage of pancreatic pseudocysts can be both safe and effective, and definitive treatment. It should be cons idered as an alternative option before standard surgical drainage in select ed patients.