Extended drainage procedures in surgical treatement of chronic pancreatitis – Frey procedure

s / Pancreatology 12 (2012) 502–597 567 Objective: Analysis of patients operated for pancreatic pseudocysts during 5 year period Patients and methods: During the period from 2005 to 2010, a total of 101 patients were treated for pancreatic pseudocysts in our depatement at First Surgical Clinic, Belgrade, Serbia. They were retrospectively reviewed and followed up. There were 68% men, between 18 and 85-years-old (mean age 58,3 years). Results: Dominating symptoms in most patients were epigastric pain, palpable mass, nausea, vomiting, fever and leukocytosis, and persistent elevationof serumamylase. Imaging studies, such asultrasound, CTscan, and ERCP were were used in establishing the diagnosis. Operative procedures consisted of external drainage (ED, 9 cases), internal drainage using cystojejunostomy (CJ, 85% cases) and cystogastrostomy (CG,10 cases), and distal pancreatectomy (4 cases). The following complications were observed including recurrence of cyst (1 patient with ED and 1 with CJ), delayed massive bleeding (1 with CG), pancreatic fistula (3 with ED, 3 with CJ, 1 with CG), pancreatic abscess (1 with CJ) and persistent pain (1 with CG). Reinterventionwasneeded to stopbleeding in1patientwithCG.Nodeathsoccurred. Conclusion: Although complications do occur in surgical treatment, cystojejunostomy is still gold standard for treatment of pancreatic pseudocysts.