[Pancreatic pseudocyst--diagnosis, evolution, surgical treatment].
BACKGROUND: The pancreatic pseudocyst (PP) represents one of the most common complications of acute and chronic pancreatitis, patients with this severe pathology often undergoing surgical treatment. PATIENTS AND METHOD: This paper evaluates 133 cases that underwent surgical procedures for PP in the 3rd Surgical Clinic Cluj-Napoca during January 1993-April 2003, from a diagnostic and therapeutic point of view, emphasizing the modern imagistic methods for diagnosis and the modern surgical approach to PP. RESULTS: In 105 cases (79%) an internal drainage procedure was performed (including three cases that underwent laparoscopic drainage procedures and one case undergoing a laparoscopy assisted drainage procedure, all four cases with favorable postoperative outcome), external drainage procedures were performed in 25 cases (19%) and in three cases (2%) a pancreatic resection was performed. External drainage was performed only when internal drainage was not possible. Postoperative complications occurred only in patients with externally drained PP. DISCUSSION: The results of this study confirm that the internal drainage of PP, especially using the limb of jejunum Roux-en-Y technique (67 cases, 50%), represents the best approach to PP surgery, laparoscopic procedures being a valid option in performing an internal drainage.