[Transcutaneous drainage of pancreatic pseudocysts guided by ultrasound and computed tomography]

Abstract

The method of transcutaneous sanation of pancreatic pseudocysts under control of USE and CT has developed quite widely in the recent years and is applied in clinical practice. In the period from 1987 to May 1993 thirty-three patients underwent transcutaneous drainage (TD) of pancreatic cysts at the Burdenko Facultative Surgical Clinic, MMA; a total of 35 procedures were performed. In all cases TD was conducted under control of USE and roentgeno-television (RTV) by Seldinger's method or with various types of stylet catheters. The transperitoneal approach was preferable in cysts of the head, in cysts of the body of the gland hze transgastric approach was used under control of gastroscopy for later attempt to accomplish transcutaneous cystogastrostomy. Contrast examination of the cyst immediately after puncture revealed its connection with the pancreatic duct (PD). Fistulography was repeated every 5-7 days. In the absence of a cystopancreatic fistula the cyst was sclerosed with 96 degrees ethyl alcohol. Complications were encountered in 11% of cases and a recurrent cyst developed in one patient. The TD method under control of USE and RTV is effective in the treatment of pancreatic cysts attended by a low incidence of complications. A large size of the cyst, its infection or connection with the pancreatic duct are not contraindications for TD.