Abstract

THE TREATMENT of pancreatic pseudocysts has undergone considerable evolution since the first attempts at surgical treatment by Le Dentu 19 in 1862 (aspiration) and by Lucke and Klebs 20 in 1866 (external drainage), both of which ended fatally. Bozeman 1 successfully removed a cyst weighing 20½ lb from the tail of the pancreas without ligating a blood vessel in 1882, a remarkable feat even now. Excision is no longer the treatment of choice. The inflammatory nature, lack of a true capsule, adherence to vital structures, and frequent location of the pseudocyst in the head of the pancreas preclude successful excision most of the time. Meyer and associates 23 and Murphy and Hinkamp 26 reported a total of 66 cases of pseudocysts; in five of these, treatment was by excision. In a review of the literature between 1945 and 1958, Warren and co-workers 38 found 48 cases (10%) in which excision

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