[Therapy of post-necrotic pancreatic pseudocysts: invasive treatments and their results]. / Terapia delle pseudocisti pancreatiche postnecrotiche: trattamenti invasivi e loro risultati.

Pancreatic pseudocysts are the most common lesions of the pancreas. Endoscopic and US-endoscopic techniques are today the best minimally invasive diagnostic and therapeutic procedures available for this pathology. From January 1980 to December 2001 we observed a total of 74 patients with pancreatic pseudocysts secondary to acute pancreatitis. Twelve patients were treated by medical therapy, 37 with a surgical approach, 15 by endoscopic drainage and 10 by CT-guided drainage. The mean size of the pseudocysts was 12.9 cm (range: 3.4 to 24 cm) and 69.4% were larger than 10 cm. CT-guided drainage had a 50% complication rate (P = 0.00814), a 20% mortality rate (P = 0.00463) and a 10% relapse rate. The surgical approach was associated with a complication rate of 18.9% and a 5.4% relapse rate. The endoscopic approach presented a 13% morbidity rate and a 6.6% relapse rate. CT-guided drainage is the therapeutic approach we use in emergency cases, but endoscopic therapeutic technique is the best procedure and is a valid alternative to surgical and CT-guided drainage. The shortest mean hospital stay (4.8 days) was observed with the endoscopic approach.