Percutaneous aspiration and drainage of pancreatic pseudocysts

Twenty-five patients with pancreatic pseudocysts had therapeutic intervention procedures that included diagnostic aspiration, short-term drainage (aspiration until completely drained), and long-term catheter drainage. Diagnostic aspirations were used to classify the pseudocysts as infected or noninfected. Short-term drainage was performed on six pseudocysts (two infected and four noninfected) with little success. One resolved and five recurred. Fifteen pseudocysts were treated by long-term catheter drainage. Eight of these (four infected and four noninfected) resolved after initial long-term drainage; two others resolved after additional drainage. The cure rate in these 15 patients was 67%. The other five patients were treated surgically after they had been stabilized but not cured by percutaneous drainage. Complications were few and uniformly minor except for one pneumothorax. Percutaneous aspiration should be used in the diagnosis of pancreatic fluid collections. In noninfected pseudocysts, drainage can be curative. In infected pseudocysts, percutaneous drainage is useful to stabilize the patient and can be either a cure or a temporizing measure until surgery can be performed.
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