TREATMENT OF PANCREATIC PSEUDOCYST COMPLICATED BY BLEEDING

Aim. To evaluate an effectiveness of various surgical methods for pancreatic pseudocysts complicated by bleeding.

Material and Methods. The results of surgical treatment of 31 patients with pancreatic pseudocysts complicated by bleeding (false aneurysm type I) were presented. Patients were divided into two groups depending on surgical treatment: group 1 (15 patients) – laparotomy, intraoperative hemostasis and external drainage of pancreatic pseudocyst; group 2 (16 patients) – selective angiography with vascular embolization followed by US-assisted external percutaneous drainage of pancreatic pseudocyst.

Results. An effectiveness of various surgical techniques was assessed by the incidence of severe sepsis and mortality rate. There were no cases of severe sepsis and lethal outcomes after minimally invasive treatment while in the 1st group severe sepsis developed in 33,3% (5 patients), mortality was 20,0% (3 patients).

Conclusion. Minimally invasive measures are optimal for pancreatic pseudocysts complicated by bleeding. Laparotomy is advisable if minimally invasive interventions are impossible due to various reasons. 

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