The Impact of Technology on the Management of Pancreatic Pseudocyst

Walt, Alexander J.; Bouwman, David L.; Weaver, Donald W.; Sachs, R J

doi:10.1001/archsurg.1990.01410180085014

Cited by 50 publications

(25 citation statements)

References 26 publications

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“…Morbidity and mortality rates for ruptured pseudocysts in our series were 50 and 29%, respectively, figures which are similar to those previously reported. 6,27 Conclusion In summary, APP associated with pancreatic necrosis after an episode of SAP requires careful evaluation and treatment. In patients with complicated APP and organ failure, percutaneous or endoscopic drainage should be performed as a temporizing measure to alleviate sepsis and improve the patient's condition.…”

Section: Discussionmentioning

confidence: 97%

“…[1][2][3] Despite this progress, the timing and treatment of patients who develop acute pancreatic pseudocysts (APP) after an episode of SAP remains controversial. [4][5][6] Many of the reasons for this controversy reside in imprecise definitions, mixed case series of treatment outcomes in both acute and chronic pancreatic pseudocysts, and the fact that the disease process of SAP with pancreatic necrosis represents a wide spectrum of tissue destruction, fluid sequestration, and systemic toxicity, which is often difficult to accurately categorize. 1,7 Acute pancreatic pseudocysts are defined as a collection of amylase-rich pancreatic fluid, enclosed in a well-circumscribed wall, that has been present for more than 4 weeks after the episode of SAP.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Acute Pancreatic Pseudocysts After Severe Acute Pancreatitis

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Zandalazini

et al. 2007

Journal of Gastrointestinal Surgery

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Treatment of acute pancreatic pseudocysts (APP) after an episode of severe acute pancreatitis (SAP) remains controversial. Both population heterogeneity and limited numbers of patients in most series prevent a proper analysis of therapeutic results. The study design is a case series of a large, tertiary referral hospital in the surgical treatment of patients with APP after SAP. An institutional treatment algorithm was used to triage patients with complicated APP and organ failure based on Sequential Organ Failure Assessment scores to temporizing percutaneous or endoscopic drainage to control sepsis and improve their clinical condition before definitive surgical management. Over a 10-year period of study (December 1995 to 2005), 73 patients with APP after an episode of SAP were treated, 43 patients (59%) developed complications (infection 74.4%, perforation 21%, and bleeding 4.6%) and qualified for our treatment algorithm. Percutaneous/endoscopic drainage was successful in controlling sepsis in 11 of 13 patients (85%) with severe organ failure and allowed all patients to undergo definitive surgical management. The morbidity (7 vs 44.1%, P = 0.005) and mortality rates (0 vs 19%, P = 0.04) were significantly higher in complicated vs uncomplicated APP. Acute pancreatic pseudocysts after SAP are unpredictable and have a high incidence of complications. Once complications develop, there is a significantly higher morbidity and mortality rate. In complicated APP with severe organ failure, percutaneous/endoscopic drainage is useful in controlling sepsis and allowing definitive surgical management.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Treatment of Acute Pancreatic Pseudocysts After Severe Acute Pancreatitis

Ocampo

Oría

Zandalazini

et al. 2007

Journal of Gastrointestinal Surgery

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“…All patients were managed via a multidisciplinary approach consisting of pediatricians, pediatric gastroenterologists, and pediatric surgeons. Patients with traumainduced PP incurred injury through motor vehicle accidents (5), bicycle bar injuries (3), farm injury (1), horse kick injury (1), and sport-related injury (1). Etiologies of PP in the nontrauma group included idiopathic pancreatitis (6), familial pancreatitis (4), drug-induced pancreatitis (1), gallstone pancreatitis (1), and pancreatic duct anomaly (1).…”

Section: Patientsmentioning

confidence: 99%

Pancreatic pseudocyst in children: the impact of management strategies on outcome

Teh

Pham

Lee

et al. 2006

Journal of Pediatric Surgery

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“…[5] It has been demonstrated in a majority of related studies that PPs larger than 5 or 6 cm have lower rates of spontaneous resolution. [8][9][10][11] Authors have emphasized that, depending on size, early operation or drainage of pseudocyts improves rates of morbidity and mortality. [12] Therefore, it is strongly suggested that surgical or percutaneous drainage be considered in cases of PPs larger than 6 cm.…”

Section: Discussionmentioning

confidence: 99%