Algorithm of pancreatic cysts treatment in patients with chronic pancreatitis

Abstract

Introduction. The number of the patients with pancreatic cysts recently increases with count of cases of acute and chronic pancreatitis. Most of them needs surgical treatment because of its complications: infection, bleeding, rupture. The aim of our investigation were to analyze the results of pancreatic cysts treatment and development of its treatment algorithm. Material and methods. The results of surgical treatment of 125 patients with pancreatic pseudocysts were submitted that treated from 2000 till 2018 years. All patients before surgery procedure did CT, we check pressure inside the pancreatic cysts and rate the severity of pain. Results: Patients with pancreatic cysts were operated: internal draining (61), external draining (29), external-internal draining (18), local resection of pancreas (12), endoscopic cystogastrostomy (5). When cysts were without complication in 58.1%(73) we did internal draining and resectional procedures. In 47 patients with complicated cysts we did external draining (29) or combined external-internal draining (18). Conclusion: If increased main pancreatic duct diagnosed and there are connection of main pancreatic duct with a cyst lumen that is indication to resectional procedure – local pancreatic resection by Frey-Izbicki. If there are present pancreativ hypertension the external draining accompanied with pancreatic fistula formation in 34.4%, than in 13.8% need surgical procedure. Internal draining are safe surgical procedure with low postoperative morbidity and mortality.