Background: Pancreatogenic splenic pseudocysts are a relatively rare condition. Intra-splenic localization is of the splenic pseudocysts is dangerous because of the possibility of massive haemorrhage and organ rupture. Aim: To analyse our experience in the diagnosis and treatment of pancreatogenic pseudocysts of the spleen. Materials and Methods: The analysis of the short and long-term results of treatment of the 34 patients with pancreatogenic splenic pseudocysts (extrapancreatic localization) (1985-2019) was performed. In the study, the majority of male patients - 88.2%, the age of patients was 45 ± 7 years. Results: Percutaneous drainage under US-control was performed in 11 (32.4%) patients, distal pancreatic resection with splenectomy was performed in 23 (67.6%) in the cases of pancreatic tail calcific pancreatitis. In all cases of percutaneous treatment, a high level of amylase was found in the fluid from pseudocysts. Bacteriological confirmation of the growth of any bacteria in the content was not obligatory. Suppuration of the fluid of the pseudocyst was observed in 85.3% of the cases. Conclusion: Pancreatogenic pseudocysts of the spleen are one of the complications of destructive pancreatitis. They can remain undiagnosed for a long time, become infected and aggravate the course of the disease. They are often the cause of the development of sepsis and peritonitis due to the rupture of the organ capsule and bleeding into the abdominal cavity. The use of percutaneous minimally invasive methods of treatment for intra-organ pancreatogenic pseudocysts makes it possible to improve the results of treatment in this group of patients, and also, in the optimal case, be the final method of treatment.

The incidence of focal lesions in the spleen is 3.2–4.2% per 100,000 population. Spleen cysts are rare (incidence 0.75 per 100,000). These are single or multiple, thin- and smooth-walled cavities filled with a transparent liquid. Distinguish between primary (or true) cysts, lined with epithelium, and secondary (or false), devoid of epithelial lining. Among the primary cysts, there are congenital cysts formed in the embryonic period due to the migration of peritoneal cells into the spleen tissue, dermoid and epidermoid cysts. A special group of primary cysts are parasitic cysts. Cystic tumors of the spleen include lymphangioma and lymphoma.The main difficulties in the diagnosis and differential diagnosis of cysts and cystic tumors of the spleen are associated with the rarity of this pathology and, as a consequence, a small number of works, including a significant number of the cases. However, in those works where a large number of the cases are described, most often this is one morphological form and an analysis of its various characteristics.Purpose. Based on the analysis of our own examination data of a significant number of patients with cysts and cystic tumors of the spleen, to assess the possibility of differential diagnosis of individual morphological forms according to ultrasound data.Materials and methods. 323 patients with cysts and cystic tumors of the spleen from 15 to 77 years old (men – 105 (32.5%); women – 218 (67.5%) were treated at A.V. Vishnevsky National Medical Research Center of Surgery for the period from 1980 to 2020. All patients underwent ultrasound during examination. Surgical treatment was carried out in various ways – (85.1%), when making a preoperative diagnosis of an uncomplicated spleen cyst of small size, dynamic observation was carried out (verification by puncture biopsy data).Results. Morphological verification of cysts and cystic tumors of the spleen was presented as follows (taking into account possible difficulties in identifying the epithelial lining): true cyst – 182 (56.4%); dermoid cyst – 3 (0.9%) (malignant – in 1 case); pseudocyst – 16 (5.0%); pancreatogenic – 34 (10.5%); echinococcus – 52 (16.1%); lymphangioma – 24 (7.4%); lymphoma – 10 (3.1%); ovarian cancer metastasis – 2 (0.6%). The article describes the ultrasound signs of the above forms of the lesions with an emphasis on the complexity of diagnosis.Conclusions. Primary and parasitic spleen cysts are well differentiated according to ultrasound; false cysts of the spleen, depending on the cause of their occurrence, can create difficulties in their identification and differentiation (they require careful dynamic control); cystic tumors of the spleen should be differentiated from malignant tumors and metastases of a cystic structure, as a result of which such vigilance should always be present when they are detected.

No abstract

No abstract

Results: Sixty-six affiliations enrolled 4,112 cases. Hepatocellular carcinoma, colorectal liver metastasis consisted of 58.0% and 26.7% of the cases, respectively. The most frequent difficulty score was 3 (20.7%), followed by 5 (19.2%), and 2 (14.7%). The median operation time was 268 min, and median blood loss was 120 mL. Major complications occurred in 205 cases (5.0%) and were significantly associated with intraoperative blood loss, serum albumin level, extent of liver resection, operation time, blood transfusion, and the difficulty score. Overall, 30 day-and 90 day-mortality was 0.14% and 0.41%, respectively. Conclusions: LLR was performed with acceptable mortality and morbidity before the starting of the registry system.