Modern Approaches to the Treatment of Chronic Pancreatitis Complicated by Pancreatic Pseudocysts

Abstract

Aim. Retrospective analysis of conventional and endoscopic surgical treatment of patients with chronic pancreatitis complicated by pancreatic pseudocysts. Material and Methods. For the period from 2011 to May 2017 two hundred and eighty-two patients were treated for chronic pancreatitis. In 91 (32.3%) patients disease was complicated by post-necrotic pancreatic cysts. 38 patients underwent conventional or laparoscopic surgical treatment. Minimally invasive surgical treatment including endosonography-assisted cystogastro-/ cystoduodenostomy was offered to 38 patients. 15 patients with symptomless pancreatic pseudocysts ≤ 5 cm are under follow-up. Results. Mean hospital-stay was 11.2 and 6.4 days after cystojejunostomy and endoscopic drainage respectively. Postoperative morbidity was 10.5% (n = 4) per each group. There were more severe complications after conventional procedures: Clavien–Dindo grade II in 1 patient, grade IIIb in 3 patients. At the same time endoscopic surgeries were followed by complications grade II in 3 patients and grade IIIb in 1 patient. Mean life quality score was 70.2 and 74.3 after traditional and endoscopic interventions respectively. Postoperative follow-up was 3 years for all patients. Conclusion. Internal endosonography-assisted endoscopic drainage of pancreatic pseudocysts may be preferable in patients with chronic pancreatitis.