What is the treatment for a pancreatic pseudocyst?

Question

Hello doctor,

My brother is 43 years old. He had an episode of acute pancreatitis last year. Gas and indigestion persisted since then. A recent CT scan has shown a possibility of pancreatic pseudocyst formation.

The doctor has advised removing the same through the procedure. My query regarding this is whether the pseudocyst can be treated with medicines or if a procedure is recommended. And if yes, whether a laparoscopic procedure can be opted. What are the advantages and disadvantages? Is there a chance of the pseudocyst being formed again after the procedure?

I am currently on Atowa Aony, Prankeeatoflat, Sompray D, VSC 3#, and Telma AM.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

When did he have the first episode of pancreatitis?
What is the size of the cyst by ultrasound?
What are serum amylase or lipase levels?
Is he a diabetic?
Is he an alcoholic?

Will you please answer the above questions if possible?

If a pseudocyst is usually acute, we will wait for four to six weeks for recovery. If it is not recovering with medication or increasing the size in sequential CT (computed tomography) scans, or it is causing any complications (adjoining vessel compression or size > 5 cm or infected or causing bowel obstruction or symptoms of decreased appetite or weight loss) need surgery. Yes, you may undergo laparoscopic pseudocyst gastrostomy or cystojejunostomy.

For this procedure, experienced hands are needed, and the long-term outcome is not known. But with less morbidity and a higher success rate. Yes, in 15 to 18% of cases, recurrence.

I hope this helps you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I understand your concern.

I have undergone all of your reports (attachment removed to protect patient identity). The cyst size is 17 ×11×15 and it is compressing the adjoining structures, so need an intervention. It is better to undergo endoscopic surgery to decompress the cyst. So please consult a surgical gastroenterologist nearby; he will examine and treat you accordingly.

I hope this helps you.

Thank you.