A clinical study on pseudo-cyst pancreas: Clinical presentation, surgical, and different modalities of treatment and outcome

Abstract

BACKGROUND: Pancreatic pseudocysts are walled-off collections of necrotic tissue, old blood, and secretions that are encapsulated. Collections lack a real capsule, and the cyst wall is composed of nearby viscera such as the stomach and/or colon. Pseudocysts are the most frequent side effects of both acute and chronic pancreatic inflammation. In our prospective interventional study, 25 patients with symptomatic pancreatic pseudocysts were included. Majority of patients were belonged to the age group of 31–40 years, with males being more common. The most common cause is alcoholism, followed by idiopathy. Most of them presented with pain abdomen as the chief complaint. Ultrasonography (USG) and computed tomography (CT) of the abdomen were found to be accurate investigations. Acute pseudocysts were managed conservatively, whereas infected cysts necessitated external drainage. In the majority of cases, anastomoses of the cyst to the nearby bowel, either cystogastrostomy or cystojejunostomy, were performed with good results. METHODS: Study design - Hospital-based prospective interventional study. Sample size - 25. The study was the prospective interventional study, conducted at Basaweshwar Hospital from July 2020 to August 2022, 25 patients with symptomatic pancreatic pseudocysts included. Patients had baseline tests as well as specific tests such as serum amylase and serum lipase. All patients underwent USG and CT Abdomen to determine the morphology, and treatment was planned accordingly. RESULTS: A total of 25 patients were included in the study. Out of 25 patients, the cause of pancreatic pseudocyst was found to be alcohol consumption in 80% and other causes in 14%. The common indication for intervention was persistent pain (60%) The type of intervention was chosen based on the physical state of the patient as well as the location and type of the pseudocyst. USG-guided drainage was done in 14% and surgical drainage procedure-cystogastrostomy - 36% and cystojejunostomy 26%. CONCLUSION: The most common cystic lesion of the pancreas is the pancreatic pseudocyst. The disease was common in the age group of 31–50 years and was seen predominantly in males. The most common cause is alcoholism, followed by idiopathy. Pain in the abdomen with tenderness is a common presentation. The most useful tests were an ultrasound and a CT scan. Acute pseudocysts were managed conservatively, while infected cysts required external drainage. In the majority of cases, anastomosis of the cyst to the nearby bowel, either by cystogastrostomy or cystojejunostomy, was performed with good results.

Keywords

• cystogastrostomy
• cystojejunostomy
• pancreas
• pseudocyst