Pancreatic pseudocysts are the collection of fluid around the pancreas, usually consisting of pancreatic fluid that has leaked out of a damaged duct. These pseudocysts usually occur on the body after acute pancreatitis, sometimes soon after the attack, sometimes many weeks or even months after recovery.

Patients suffering from pancreatic pseudo cysts commonly feel a pain in the abdomen, a feeling of bloating, and poor digestion of food. Complications that arise from pseudocysts include an infection of the cyst with a pancreatic abscess, bleeding into the pseudocyst, and blockage of the intestine.

Diagnosis of a pseudocyst is made easier with the help of a CT scan, which can accurately take a picture of the fluid filled mass around the pancreas. For some people pseudocysts can often be mistaken for cystic tumors such as mutinous cyst adenoma, or worse the other way around. For this reason it is recommended to get an evaluation by a radiologist or a surgeon to get an accurate diagnosis.  In some cases pseudocysts can improve and heal on their own. In patients with cysts smaller than 6cm that aren’t causing any problems, simple periodic observations with the CT scans are all that is needed. Only if the pseudocyst is persistent and painful will it require treatment. 

For those suffering from a pseudocyst there are multiple treatment options available. These pseudocysts are complex and treatment should only be performed in a qualified institution where a multidisciplinary team of surgeons, gastroenterologist, and radiologists.  Surgery is the most common type of treatment for those suffering from pancreatic pseudocysts. The most common form of surgery used is referred to as a Cystgastrostomy. During this surgical procedure a connection is created between the cyst and the back wall of the stomach. The cyst then drains itself into the stomach.  Another form of surgical treatment for a pseudo cyst is referred to as a Cystjejunostomy. This procedure requires the surgeon to create a connection between the cyst and the small intestine so the cyst can drain its fluid directly into the small intestine. If the surgeon connects the cyst to the first part of the intestine so it can drain its fluid into duodenum is referred to as a cystduodenostomy.  The location of the cyst will determine which type of surgical procedure is best suited for the patient.

USC has developed a laparoscopic procedure for the treatment of pancreatic pseudocysts. This procedure is performed using minimal access techniques. When the procedure is minimally invasive the patient recovers rapidly and is commonly discharged on the second day after surgery.

Radiologists perform procedures to treat these pseudo cysts as well. In the procedure they perform they insert a thin needle into the cyst itself with the guidance of a CT x-ray and then drain all the fluid. This treatment can be initially successful but it commonly leads to a significant number of complication such as persistent leakage from the drain hole over weeks, even months, infection, and repeated procedures to drain again.