Percutaneous Catheter Drainage of Pancreatic Pseudocysts: Five Years Experience

Abstract

Objective: Pancreatic pseudocysts are common complications of pancreatitis. Pseudocysts can be treated by various drainage procedures such as endoscopic cystenterostomy or transpapillary drainage, percutaneously with image guidance or operatively. We report our experience with image-guided percutaneous evacuation of pancreatic pseudocysts. Materials and Methods: This retrospective study was conducted on 37 consecutive patients who underwent 45 percutaneous catheter placements for the drainage of pseudocysts. The catheters were introduced under ultrasound or computerized tomography guidance. The patients were followed up with a fluoroscopic catheter check for evaluation of size of collection, communication with gastrointestinal tract and the pancreatic duct. The catheter was removed when the patient was asymptomatic and the output from the catheter was less than 10 cm³ in 24 h. Results: Forty-five procedures of percutaneous drainage of pancreatic pseudocysts were performed in 37 consecutive patients. The size of the cysts ranged between 4 and 20 cm. Drainage was performed on cysts larger than 5 cm in diameter. Forty-eight percent of the patients had communication with the pancreatic duct. Percutaneous drainage was successful in 95% of the cases in our study regardless of pseudocyst communication with the main pancreatic duct. The average duration of catheter drainage was 30 days in cases without communication versus 33 days in patients with communication with the pancreatic duct. Conclusion: Percutaneous drainage is a safe and effective alternative to surgery in patients with pancreatic pseudocysts. The duration of catheter drainage in cases with or without communication with the pancreatic duct was nearly the same.