Original Article

Pediatric Surgery International

, Volume 29, Issue 3, pp 305-310

First online:

Non-operative treatment versus percutaneous drainage of pancreatic pseudocysts in children

  • K. W. RussellAffiliated withDepartment of Surgery, University of Utah Email author 
  • , D. C. BarnhartAffiliated withDivision of Pediatric Surgery, Primary Children’s Medical Center, University of UtahDepartment of Surgery, University of Utah
  • , J. MaddenAffiliated withDepartment of Surgery, University of Utah
  • , E. LeeflangAffiliated withDepartment of Surgery, University of California San Diego
  • , W. D. JacksonAffiliated withPediatric Gastroenterology, Primary Children’s Medical Center, University of Utah
  • , G. P. FeolaAffiliated withPediatric Interventional Radiology, Primary Children’s Medical Center, University of Utah
  • , R. L. MeyersAffiliated withDivision of Pediatric Surgery, Primary Children’s Medical Center, University of UtahDepartment of Surgery, University of Utah
  • , E. R. ScaifeAffiliated withDivision of Pediatric Surgery, Primary Children’s Medical Center, University of UtahDepartment of Surgery, University of Utah
  • , M. D. RollinsAffiliated withDivision of Pediatric Surgery, Primary Children’s Medical Center, University of UtahDepartment of Surgery, University of Utah

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Abstract

Purpose

The objective of this study was to characterize the clinical course and outcomes of children with pancreatic pseudocysts that were initially treated non-operatively or with percutaneous drainage.

Methods

A retrospective review of children with pancreatic pseudocysts over a 12-year period was completed. Categorical variables were compared using Fischer’s exact method and the Student’s t test was used to compare continuous variables. Analysis was done using logistic and linear regression models.

Results

Thirty-six children met the criteria for pancreatic pseudocyst and 33 children were treated either non-operatively or with percutaneous drainage. Of the 22 children managed non-operatively, 17 required no additional intervention (77 %) and five required surgery. Operative procedures were: Frey procedure (3), distal pancreatectomy (1), and cystgastrostomy (1). Eight of the 11 children treated with initial percutaneous drainage required no additional treatment (72 %). The other three children underwent distal pancreatectomy. Success of non-operative management or percutaneous drainage was not dependent on size or complexity of the pseudocyst Logistic regression did not identify any patient demographic (gender, age, and weight), etiologic (trauma, non-traumatic pancreatitis) or pseudocyst characteristic (size, septations) that predicted failure of non-operative therapy.

Conclusions

In children, pancreatic pseudocysts can frequently be managed without surgery regardless of size or complexity of the pseudocyst. When an intervention is needed, percutaneous drainage can be performed successfully, avoiding the need for major surgical intervention in the majority of patients.

Keywords

Pancreatic pseudocyst Pediatrics Non-operative management Percutaneous drainage