Clinicopathological features of Pseudocyst Pancreas and its Management: A Prospective and Retrospective Study

Abstract

Background: Revised Atlanta Classification has veered a change in our understanding ofpseudocyst pancreas which mandates renewed inquiry into pseudocysts defined as per new criteria.The present study provides an overview of experience with Pseudocyst Pancreas for over a decade.Methodology: 100 cases of pseudocysts diagnosed over the last 10 years at GMC, Bhopal,conforming to the present definition were reviewed. Cysts with the inhomogeneous collection,debris, necrosis, or any other non-liquid component, specifically in those diagnosed before 2012were excluded. Relevant data were analyzed. Results: The majority were male (85%) in the agegroup of 40-50 years with alcohol-induced chronic pancreatitis (77%) being the most frequentetiology. Abdominal pain (40%), lump (30%), and abdominal tenderness (59%) were common atpresentation. 58% were in the Head of the pancreas, 29% in the Neck and Body, and 13% in theTail and surrounding areas. Mean cyst diameter was 8.6cm and volume 252cc. 85% were managedsurgically and 40% of those managed conservatively also needed surgical intervention eventuallydue to complications. History of chronic alcoholic pancreatitis, the large size of the cyst (≥6cm and≥60cc), and communication with the main pancreatic duct were highly predictive of surgicalintervention. Conclusion: Radiological characteristics along with the clinical picture may suggestappropriate intervention. Surgery remains the principal modality of treatment, with high successrates.