Percutaneous cystogastrostomy in patients with pancreatic pseudocysts

Objective: To evaluate the results of percutaneous cystogastrostomy for pancreatic pseudocysts secondary to acute or chronic pancreatitis. Design: Retrospective study with prospective follow-up. Setting: University hospital, Sweden. Patients: 16 patients with symptomatic pseudocysts (10 men and 6 women, mean age 56 (36-78) years) treated during the period 1993-1999. Intervention: Pseudocystogastrostomy was created under local anaesthesia and fluoroscopic control by percutaneous insertion of a double pigtail catheter. Results: The underlying diagnosis was acute pancreatitis in 10 and chronic pancreatitis in 6 patients. 13 patients had one pseudocyst and 4 had 2 or more with a median diameter of 11 (5-20) cm. The procedure was successful in all but 2 patients, who were operated on. 2 patients experienced pain after the intervention that did not require specific treatment, otherwise no complications were noted. Median hospital stay was 2 days (range 1-60). The median follow-up was 45 (1-94) months. All but 2 patients had successful drainage during follow-up with resolution or regression of the pseudocyst and relief of symptoms (pain and abdominal discomfort). Conclusion: Pancreatic pseudocysts were treated by percutaneous cystogastrostomy with good results. Percutaneous cystogastrostomy is a safe, minimally invasive procedure that gives good results at long-term follow-up as well as in the short-term.