Analysis of forty-five patients with pseudocysts of the pancreas treated surgically.

The analysis of 45 patients with pancreatic pseudocysts treated surgically suggests that a significant proportion of the pancreatic pseudocysts detectable by physical examination, upper gastrointestinal tract x-ray series and sonography undergo major complications which, if neglected, may require an emergency or semiemergency type operation which, for obvious reasons, carries a higher operative mortality than when the same operation is performed electively. Therefore, pancreatic pseudocysts which are palpable and reontgenographically distort the anatomy of the upper part of the abdomen should be operated upon electively but promptly. Internal drainage by a cystogastric stoma or cystojejunal stoma, the latter being most favored in this series, apppears to be the best choice. Realistically, expectations are satisfactory results in 85 per cent of the patients, a recurrence rate of about 7 per cent and unsatisfactory results in about 12 per cent. Recurrent cysts are, in most instances amenable to a second surgical procedure.