Treatment of Pancreatic Pseudocyst in the Tail of the Pancreas with Distance <1 cm to the Gastrointestinal Wall
This protocol addresses pancreatic pseudocyst specifically located in the tail of the pancreas where the pseudocyst lies less than 1 cm from the gastrointestinal wall, with no splenic vein involvement and no upper gastrointestinal bleeding present.
The pseudocyst is situated in the pancreatic tail. There is no splenic vein involvement and no upper gastrointestinal bleeding. The distance between the pseudocyst wall and the gastrointestinal wall is less than 1 cm — a proximity that is central to determining the appropriate drainage strategy.
Management involves surgical internal drainage. The choice among specific operative procedures depends on anatomical and patient-specific factors. The full structured protocol details which procedure applies and under what conditions.
References
DOI: 10.1097/MD.0000000000000960
In patients without splenic vein involvement or upper gastrointestinal bleeding and with a <1 cm distance between the pseudocyst and the gastrointestinal wall, endoscopic drainage via cystogastrostomy or cystoduodenostomy should be performed.
The operative procedures performed were Roux-en-Y cystojejunostomy in 21 patients (42.9%), cystoduodenostomy in 15 patients (30.6%), cystogastrostomy in 7 patients (14.3%), and distal pancreatectomy in 6 patients (12.2%).
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