Diagnosis and differential approach to the choice of treatment of pseudocysts of the pancreas.

Abstract

A prospective study of 182 patients with pan­creatic pseudocyst was conducted. By studying changes in ion-acid-alkaline status of cysts cavity, the correlations between these indicators, indicators of proteinogram of blood, findings of ultrasound examination and computed tomography were established. The algorithm for surgical treatment of pancreatic pseudocysts for each of the clinical groups of patients has been developed. Patients of the first group underwent interventions mainly in the cyst, as the structural changes in the pancreas were minor and did not require correction. In the second group 63.16% of patients underwent draining operations, in 57.89% of patients it was the final treatment stage, and 15.80% required the correction of manifestations of chronic pancreatitis. In the third group of patients pancreas was almost completely damaged by chronic inflammation of fibrous-degenerative character, calculosis, ductal hypertension, there with mostly direct interventions were performed on the pancreas. New approaches pathogenetically justify differential surgical treatment strategy for pancreatic pseudocyst using both minimally invasive and open surgery.