THE TIMING OF SURGICAL-TREATMENT OF PANCREATIC PSEUDOCYSTS

Abstract

Practical guidelines for the management of pancreatic pseudocysts are discussed. The results in 114 patients who were analyzed from the perspective of the timing of operative intervention are presented. Overall, the patients undergoing surgical therapy during the 1st wk after pseudocyst formation had higher morbidity, mortality and recurrence rates postoperatively than did those treated later in the course of the disease. The results in patients with uncomplicated pseudocysts were similar, irrespective of the timing of operative treatment. Operative intervention in patients with a pseudocyst who were acutely ill was risky at any time in the course of the disease. The optimal timing of the operation in patients with uncomplicated pseudocysts is apparently .apprx. 4 wk after formation of the mass. The utility of ultrasound evaluation in making a surgical decision is also discussed.