Pancreatic Disorders & Therapy
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Pancreatic Pseudocysts and its Treatment

Ciara Warfvinge^{* *}Correspondence: Ciara Warfvinge, Department of Digestive Diseases and Internal Medicine, Sant Orsola-Malpighi Hospital Bologna, Emilia-Romagna, Italy, Email:

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Description

Pancreatic pseudocyst is generally characterized by the collection of fluid rich in pancreatic enzymes, blood, and necrotic tissue, which arises as a complication of pancreatic [1]. Injury to the pancreas causes the leakage of digestive juices into the intestine due to which they do not get absorbed. So, in order to protect or stop this leakage a capsule or a protective wall is developed which is called as false or pseudocyst.

Depending on the nature of the pseudocyst (size, location, or cause), some will improve on their own, while others require treatment. If the cyst does not cause any severe implications or symptoms like pain or swelling the doctor might not prescribe any test. But if the cyst gets larger, causing severe pain, it implies that it might require surgical treatment.

There is high risk among people who consume alcohol, and acute pancreatic [2-4]. High levels of triglycerides, presence of injured gallbladder or injury to the abdomen may be the cause for pseudocystic pancreatic.

Signs and symptoms

• Nausea, vomiting

• Abdominal swelling

• Breath shortening

• Pale or yellow skin and eyes

Diagnosis

Pancreatic cysts can be diagnosed using of cross-sectional imaging techniques, such as CT scans and MRI. It is very important to diagnose the cysts else there may be chance for the cysts to become more cancerous. Additionally, cyst classification would be beneficial in the determination of whether the cyst is malignant or not and upon which it reveals whether to undergo a surgery or not. Especially, pancreatic cysts are diagnosed using Endoscopic Ultra Sound (EUS), which presents a detailed visualization of pancreas [5]. In addition, sometimes use of stent and tube can also be beneficial to drain the cyst. This method is followed by radiologists. There are some other endoscopic procedures as listed below-

Echoendoscopy: This method uses an endoscope with an ultrasound transducer at the tip, which helps to drain the pseudocyst.

Cystogastrostomy: In this method, back wall of the stomach and the cyst is directly drained into the stomach.

Cystojejunostomy: The cyst and the small intestine are closely connected in such a way that the cyst fluid can drain directly into the small intestine.

Cystoduodenostomy: Similarly, in this method the cyst is connected to the duodenum such that the cyst is allowed to drain into the duodenum.

Endoscopic Retrograde Cholangiopancreatography (ERCP): It is a method which combines X-ray along with the use of an endoscope. This helps to view problems associated with the digestive organs, including the pancreas.

Surgical therapies

Psuedocystic pancreatis might require surgical treatments which would either minimize the disorder or reduce the complication to a lower level. Generally in a surgical method, a connection between the psudocyst and a nearby organ that may either be small intestine or stomach or duodenum as per the location of the cyst. This is followed in order to drain the cyst. In other cases, laparoscopy is also followed, through incisions in the abdomen using some specialized tools. This allows reducing the recovery time. Pseudocystic pancreatic can also be treated using an endoscopic outpatient surgery, namely Cystogastrostomy [6]. This method is followed when pancreatic pseudocyst develops either after acute pancreatis or chronic pancreatis. In this method, pseudocyst is drained out by creating an opening or inserting a stent between the cyst and the stomach.

Conclusion

Pancreatitic pseudocysts are considered to be quite common issue that is encountered at all ages equally among men and women. No medications are specific to the treatment of pancreatic pseudocysts. However, the treatment of approach varies according to the type of cause and the risk. Moreover it has to be understood that not all types of cysts lead to cancer. So, it is very crucial to monitor the cysts for changes and growth. Endoscopic drainage technique is the least complicate option, which has the lowest risk and can be considered to be safe and effective.

References

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