Pancreatic pseudocyst: a therapeutic predicament

Abstract

Background: To compare effectiveness between USG guided aspiration technique and percutaneous drainage for resolution of pseudo pancreatic cyst. Methods: In this interventional-analytic study, Twenty five patients with pancreatic pseudocyst were divided in two group, one group with nine patients undergone USG guided aspiration of cyst, while another group of sixteen patients managed by percutaneous drainage technique. As there were very few studies which compared directly these approaches, management varies based on local expertise, so we planned this study to select preferred approach between these modalities. Approval from Institutional ethics committee was taken before starting the study. The study was explained to patients in brief in a language they can understand. Consent of participants was taken in written informed consent form. Results: Out of the 25 patients enrolled in the study, 20 (80%) were males and 5 (20%) females. The most common aetiology of the pancreatic pseudocyst was alcoholism (all males), however, two cases were the result of blunt abdominal trauma. Out of five females, three had gallstone pancreatitis, and two were idiopathic. Conclusions: Though this study shows though aspiration technique is less time consuming, with low incidence of complications. Hospital stay is also apparently less in aspiration technique, but in term of complete resolution and /or less chance of recurrence per cutaneous drainage technique shows better results. As our study included only 25 patients with pancreatic pseudocyst which limits the statistical significance of its results, so a tailored therapeutic approach should be consider which involve patient preferences, multidisciplinary team of therapeutic endoscopist, interventional radiologist and pancreatic surgeon, in all cases.