Pseudocyst in Chronic Pancreatitis

  • – Pseudocyst occurs in 25% CP patients
  • – Most commonly seen in alcoholic patients
  • – Presentation:
  •                • Abdominal pain
  •                • Palpable mass
  •                • Nausea, vomiting
  •                • Jaundice
  •                • Bleeding
  •                • Asymptomatic
  •                • Persistent elevation of amylase, lipase
  • – 70% pseudocyst communicates with pancreatic duct
  • – Complications of pseudocyst occur in 20-40% patients
  • Complications of Pseudocyst:
  •       • Compression of peripancreatic vessel, duodenum,stomach
  •       • Infection
  •       • Hemorrhage
  •       • Fistula
  • – Pseudocyst of CP resolves less commonly in comparison to pseudocyst of Acute Pancreatitis
  • – Treatment is not necessary in all patients
  • Treatment is required in
  •         • Very large pseudocyst
  •         • Enlarging pseudocyst
  •         • Symptomatic pseudocyst
  •         • Complicated pseudocyst
  • Endoscopic therapy of pseudocyst:
  •          – Trans papillary drainage:
  •                  • Preferred for small pseudocyst in the head of the pancreas that communicates with pancreatic duct (PD)
  •         – Transmural drainage
  • Surgical therapy of pseudocyst:
  •           – Cystogastrostomy
  • Figure: Diagram of Cystogastrostomy
  • – Cystojejunostomy
  • Figure: Diagram of Cystojejunostomy
  • – Sometimes Coupled with PD drainage procedure (Modified puesto procedure)

Copyrights © 2021 Arefin | Gastroenterology | Developed by Chumbok IT