This protocol applies to patients presenting with a ruptured pancreatic pseudocyst, or with a symptomatic or infected mature pancreatic pseudocyst, whose overall clinical condition (weak body situation) prevents them from undergoing a standard surgical procedure.
External drainage is indicated for ruptured cysts and for patients with symptomatic or infected mature cysts in the setting of a weak body situation. Patients in this category who cannot tolerate operation are managed through a non-operative drainage approach; however, a subset of such patients ultimately requires further intervention.
Management in this scenario includes a surgical option that becomes necessary for selected patients who do not achieve adequate resolution with the initial approach. The full protocol specifies the indications, decision thresholds, and sequencing for each step.