Endoscopic Treatment of Pancreatic Cysts and Pseudocysts

Abstract

Pancreatic cysts and pseudocysts are cavities containing pancreatic juice, either pure or mixed with necrosis debris or blood, contained or not within the pancreas from which they arise [1]. Anatomoclinical forms of pancreatic cysts are numerous. Besides cystic tumors such as cystadenomas and cystadenocarcinoma or parasitic cysts or congenital cysts, the most frequent varieties are observed during chronic pancreatitis and acute pancreatitis. In chronic pancreatitis, most cysts and pseudocysts are secondary to partial or complete ductal obstruction due to stenosis or intraductal stones or both phenomena. Distension of the ductal system results proximally to the obstacle. At the beginning, cysts are intrapancreatic collections, but when they grow, they can reach the capsule of the pancreas. If the capsule ruptures, cysts can sometimes migrate less far from the pancreas and are then limited by the neighboring organs or by a fibrous layer. These are called retention pseudocysts. Pseudocysts can also complicate acute pancreatitis, whatever the etiology (biliary acute panceatitis, acute attacks superimposed on chronic pancreatitis, for example). In this instance, necrotic pseudocysts result from the rupture of the ductal system.