Nonoperative management of pancreatic pseudocyts: Problems in differential diagnosis

Ugo Boggi, Giulio Di Candio, Alessandro Campatelli, Andrea Pietrabissa, Franco Mosca

Research output: Contribution to journalArticle

Abstract

Background. The accurate diagnosis of pancreatic cystic lesions remains a problem. The aim of this study was to ascertain the incidence of and the reasons the diagnostic errors occurred in a series of pseudocysts drained percutaneously and to compare these data to those reported in the literature. Methods. Data from 70 patients bearing one or more pseudocysts who underwent a percutaneous drainage were reviewed. The pretreatment workup included medical history, physical examination, ultrasound (US) and computed tomography (CT) scans, amylase assay in both the serum and the cystic fluid, culture and cytology of the cystic fluid. After removal of the drainage, the minimum follow-up period was 12 mo. Results. Four patients died, and two cancer-associated pseudocysts were identified before removal of the drainage. Sixty-four patients were followed up for a mean of 51.9 mo (range 12-154 mo). A third cancer and a mucinous cystic tumor, fully communicating with the main duct, were further detected during this period. Conclusion. The evaluation of pancreatic cystic lesions entails a misdiagnosis risk. Awareness of the problem, knowledge of the natural history of these lesions, and meticulous posttreatment follow-up can reduce the consequences of diagnostic errors. If all these precautions are adopted, pancreatic pseudocysts can be safely treated nonoperatively.

Original languageEnglish
Pages (from-to)123-133
Number of pages11
JournalInternational Journal of Pancreatology
Volume25
Issue number2
Publication statusPublished - 1999

Fingerprint

Diagnostic Errors
Drainage
Differential Diagnosis
Pancreatic Pseudocyst
Neoplasms
Amylases
Natural History
Physical Examination
Cell Biology
Tomography
Incidence
Serum

Keywords

  • Diagnosis
  • Pancreatic cancer
  • Pancreatic cystic tumor
  • Pancreatic pseudocyst
  • Percutaneous drainage

ASJC Scopus subject areas

  • Gastroenterology
  • Endocrinology
  • Oncology

Cite this

Nonoperative management of pancreatic pseudocyts : Problems in differential diagnosis. / Boggi, Ugo; Di Candio, Giulio; Campatelli, Alessandro; Pietrabissa, Andrea; Mosca, Franco.

In: International Journal of Pancreatology, Vol. 25, No. 2, 1999, p. 123-133.

Research output: Contribution to journalArticle

Boggi, Ugo ; Di Candio, Giulio ; Campatelli, Alessandro ; Pietrabissa, Andrea ; Mosca, Franco. / Nonoperative management of pancreatic pseudocyts : Problems in differential diagnosis. In: International Journal of Pancreatology. 1999 ; Vol. 25, No. 2. pp. 123-133.
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