Figure 5 - available via license: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Content may be subject to copyright.
Citations
... and even compression of mediastinal structures [11]; symptoms present in the patient presented and that are criteria for percutaneous drainage, even shortly after the diagnosis of pseudocyst, as in the clinical case, in which it was performed [3] weeks after the diagnosis was established. The development of complications of the pseudocyst itself is severe, bleeding, infection, fistula, thrombosis of the adjacent vasculature may occur secondary to "digestion" of the vascular wall by pancreatic enzymes [12] and even its rupture into a blood vessel with the consequent passage of enzymes to the systemic circulation causing a picture of arthralgia and subcutaneous purpura [13]. ...
... В настоящее время этот метод стал более предпочтительным в лечении псевдокист поджелудочной железы, поскольку он менее инвазивен, чем хирургический, и не требует наружного дренирования с высоким риском инфицирования дренажной трубки, а также имеет высокий показатель эффективности [40,45,46]. Целью ЭД при лечении псевдокист поджелудочной железы является установление связи между псевдокистой и желудочно-кишечным трактом, будь то желудок, двенадцатиперстная кишка или даже тощая кишка [36,[47][48][49]. Для ЭД используются два метода: трансмуральное дренирование (ТМД) и транспапиллярное дренирование (ТПД). ...
Background. Pancreatic pseudocysts stand among current challenges in modern medicine. Their treatment uses variant instrumental techniques and implies a multispecialty approach. Trials in surgery and gastroenterology have aimed to identify an optimal strategy to tackle pancreatic pseudocysts for reducing complications and the recurrence rate, suggesting ultrasound-guided percutaneous, laparoscopic and flexible endoscopic drainage as promising treatment choices. Objectives. A summarising review of diagnostic and therapeutic methods for pancreatic pseudocyst treatment and comparison of ultrasound-guided percutaneous vs. surgical and endoscopic drainage techniques. Methods. The review examines the classification, epidemiology and methods for diagnosis and treatment of pancreatic pseudocysts. Only comparative full-text studies published within 2014–2021, as well as selected impactive publications within 2002–2013, have been included. The eLibrary, Elsevier and PubMed resources were queried for the article or journal title fields against the keywords (separate or combined) “pancreatic pseudocyst” [псевдокиста поджелудочной железы], “pseudocyst drainage” [дренирование псевдокисты], “surgical drainage” [хирургическое дренирование], “endoscopic drainage” [эндоскопическое дренирование], cystogastrostomy [цистогастростомия], gastrojejunostomy [гастроеюностомия], “duodenal-cystic anastomosis” [цистодуоденоанастомоз], “transpapillary drainage” [транспапиллярное дренирование], “transmural drainage and esophagogastroduodenoscopy” [трансмуральное дренирование и эзофагогастродуоденоскопия]. Records have been selected for topic-related scientific value. Results. The review systematically surveys 68 scientific papers in the focus area and summarises the most common surgical methods for pancreatic pseudocyst treatment. Based on the main principle, the methods are classified into three categories, ultrasound-guided percutaneous drainage, surgical drainage and flexible endoscopic drainage. The major classifications and treatment techniques are highlighted for their advantages and disadvantages. Conclusion. There exist no generally adopted strategy for pancreatic pseudocyst treatment in current clinical practice and no evidence on a particular method application in a large patient cohort. The publication survey identifies the techniques of percutaneous, surgical and endoscopic drainage with ultrasound control as highly effective overall among other surgical treatments.
... This technique has now become the preferred therapeutic approach due to being less invasive than surgery; it avoids external drainage with the risk of tube infection and has a high long-term success rate (40,45,46). The aim of ED in the treatment of pancreatic pseudocyst is to make a connection between the pseudocyst and the gastrointestinal tract, either with the stomach, duodenum or even jejunum (36,(47)(48)(49). There are two techniques that are used for ED: Transmural drainage (TMD) and transpapillary drainage (TPD); however, there is a lot of debate surrounding these two types of drainage technique and the determination of which technique is best for treatment (50)(51)(52). ...
Advances in radiological techniques have led to an increase in the number of diagnoses of pancreatic pseudocyst, which is the most common pancreatic cyst lesion disease, accounting for two-thirds of all pancreatic cyst lesions. Historically, the management of pancreatic pseudocyst has been achieved through the use of conservative treatments and surgery; however, due to the complications and recurrence rate associated with these techniques, the management of pancreatic pseudocyst is challenging. Surgeons and gastroenterologists have attempted to determine the optimal management technique to treat pancreatic pseudocyst to reduce complications and the recurrence rate. From these investigations, percutaneous catheter, surgical and endoscopic drainage with ultrasonography guidance have become promising management techniques. The present review aimed to summarize the diagnostic and therapeutic methods used for the management of pancreatic pseudocyst and to compare percutaneous catheter, surgical and endoscopic drainage.
... The principle of treatment is drainage of pancreatic fluid using various techniques. Recent advances in endoscopic and radio intervention techniques have shown promising results; not only are a useful adjunct to surgical treatment, but in some cases, they can completely replace it [6,7,8,9,10]. However, their limited availability limits their widespread use, and management of complex mediastinal pseudocyst may still require open surgical drainage procedures. ...
Mediastinal pancreatic pseudocysts are rarely encountered complications of pancreatic diseases. Pseudocysts most often expand into surrounding structures, just rarely into the mediastinum. Usually, they present with abdominal pain, and the symptoms correlate with the location of the pseudocysts. We describe a case of a pancreatic pseudocyst that penetrated the thoracic cavity through the diaphragm and set up a communication with the bronchial tree developing an episode of massive hemoptysis. This case is of particular interest because just a few similar cases were published before. Based on this report, we emphasize the need for early accurate diagnosis; surgeons should maintain a higher index of suspicion for mediastinal pancreatic pseudocyst in patients with chronic pancreatitis.
Pancreas cysts are frequently incidentally detected on cross-sectional imaging. This review presents an approach to the diagnosis and management of pancreas cysts, including pancreas pseudocysts, serous cystadenomas and mucinous cysts, which include mucinous cystadenomas and intraductal papillary neoplasms
