A Clinical Study of 40 Gases of Pancreatic Prcudocyst

Keimyung Medical Journal 1987;6(2):346-352.

췌장가성낭종의 임상적 고찰

김인호; 손수상; 강중신

Abstract

Pancreatic pseudocyst occurs rarely in the patients with pancreatitis secondary to chronic alcohol abuse; trauma and biliary disease. Recently with the advent of the computerized tomography and ultrasonography; diagnostic accuracy and incidence has been improved. It is common that unless it resolves within 6 weeks; surgical treatment is indicated. This study consists of analysis of 40 cases of pancreatic pseudocyst which were diagnosed and treated at the department of surgery; Keimyung University School of Medicine; Taegu; Korea; during 10 years from January 1976 to December 1985. The following results were obtained: 1) The most common age group was in the 5th decade (27.5%) and male to female ratio was 4 :1. 2) Among the etiologic factors of pseudocysts; abdominal trauma was the leading cause (42.5%) and alcoholism (32.5%); unknown (12.5%); biliary disease (7.5%) and malignancy (5%) were in order of frequency. 3) The most common symptom and sign were abdominal pain (87.5%) and abdominal mass (50%). 4) Diagnostic accuracy of the abdominal CT were 100%; ultrasonogram 88.9%; and UGI 78.6%. 5) The location of the pseudocyst was in the body of the pancreas in 26 cases (65%); head in 8 cases (20%); tail in 4 cases (10%); and multiple in 2 cases (5%). 6) Among 40 cases; 8 cases were resolved spontaneously during the follow-up. Of 32 remaining cases; internal drainage was performed in 22 cases (68.8%); external drainage in 8 cases (25%) and resection in 2 cases (6.2%). Among the internal drainage; cystogastrostomy was carried out in 14 cases and cystojejunostomy in 8 cases. 7) The most common postoperative complications were wound infection and pleural effusion in 4 cases respectively and pancreatic fistula in 2 cases; pneumonia in 2 cases and recurrent pseudocyst in 2 cases. Operaitve mortality was 6.25%.