Biomaterial Database

Surgical therapy of pancreatic pseudocysts. 2008

Kevin E Behrns, and Kfir Ben-David

Department of Surgery, Division of General and GI Surgery, University of Florida, P.O. Box 100286, 1600 SW Archer Rd, Gainesville, FL 32610, USA. Kevin.Behrns@surgery.ufl.edu

BACKGROUND Pancreatic pseudocysts are a common complication associated with acute and chronic pancreatitis. Fifteen percent and 40% of patients diagnosed with either acute or chronic pancreatitis, respectively, develop pseudocysts (Grace and Williamson, Br J Surg, 80:573-581, 1993). The treatment of pancreatic pseudocysts has evolved since the early 1980s, and changes in management have lead to an improved understanding of the pathophysiology of pseudocysts as well as necessary treatment paradigms. CONCLUSIONS It has become evident that not all pseudocysts are equal. Pseudocysts arising in the setting of acute pancreatitis have a different pathophysiologic basis than those arising from chronic pancreatitis. Moreover, even those pseudocysts that arise in acute pancreatitis exhibit unique features. Pseudocysts that develop from a mild episode of pancreatitis, complicated by pancreatic duct disruption, differ significantly from those developed as a consequence of severe acute necrotizing pancreatitis with severe distortion of the pancreatic parenchyma or pancreatic duct. This review will focus on the surgical therapy of pancreatic pseudocysts in the context of the underlying pathophysiology and alternative nonoperative therapies.

UI	MeSH Term	Description	Entries
D010192	Pancreatic Pseudocyst	Cyst-like space not lined by EPITHELIUM and contained within the PANCREAS. Pancreatic pseudocysts account for most of the cystic collections in the pancreas and are often associated with chronic PANCREATITIS.	Pancreatic Pseudocysts,Pseudocyst, Pancreatic,Pseudocysts, Pancreatic
D010193	Pancreaticojejunostomy	Surgical anastomosis of the pancreatic duct, or the divided end of the transected pancreas, with the jejunum. (Dorland, 28th ed)	Pancreatojejunostomy,Pancreaticojejunostomies,Pancreatojejunostomies
D010195	Pancreatitis	INFLAMMATION of the PANCREAS. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of CHRONIC PANCREATITIS (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are ALCOHOLIC PANCREATITIS and gallstone pancreatitis.	Acute Edematous Pancreatitis,Acute Pancreatitis,Pancreatic Parenchyma with Edema,Pancreatic Parenchymal Edema,Pancreatitis, Acute,Pancreatitis, Acute Edematous,Peripancreatic Fat Necrosis,Acute Edematous Pancreatitides,Acute Pancreatitides,Edema, Pancreatic Parenchymal,Edematous Pancreatitides, Acute,Edematous Pancreatitis, Acute,Fat Necrosis, Peripancreatic,Necrosis, Peripancreatic Fat,Pancreatic Parenchymal Edemas,Pancreatitides, Acute,Pancreatitides, Acute Edematous,Parenchymal Edema, Pancreatic,Peripancreatic Fat Necroses
D010535	Laparoscopy	A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy.	Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D004322	Drainage	The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000713	Anastomosis, Roux-en-Y	A Y-shaped surgical anastomosis of any part of the digestive system which includes the small intestine as the eventual drainage site.	Roux-en-Y Anastomosis,Roux-en-Y Diversion,Roux-en-Y Loop,Anastomoses, Roux-en-Y,Anastomosis, Roux en Y,Diversion, Roux-en-Y,Diversions, Roux-en-Y,Loop, Roux-en-Y,Loops, Roux-en-Y,Roux en Y Anastomosis,Roux en Y Diversion,Roux en Y Loop,Roux-en-Y Anastomoses,Roux-en-Y Diversions,Roux-en-Y Loops
D016879	Salvage Therapy	A therapeutic approach, involving chemotherapy, radiation therapy, or surgery, after initial regimens have failed to lead to improvement in a patient's condition. Salvage therapy is most often used for neoplastic diseases.	Salvage Treatment,Therapy, Salvage,Salvage Therapies,Salvage Treatments,Therapies, Salvage,Treatment, Salvage,Treatments, Salvage
D019317	Evidence-Based Medicine	An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)	Medicine, Evidence-Based,Evidence Based Medicine,Medicine, Evidence Based