Review
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2024; 16(7): 1986-2002
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.1986
Pancreatic pseudocyst: The past, the present, and the future
Jonathan GA Koo, Matthias Yi Quan Liau, Igor A Kryvoruchko, Tamer AAM Habeeb, Christopher Chia, Vishal G Shelat
Jonathan GA Koo, Department of General Surgery, Khoo Teck Puat Hospital, Singapore 768828, Singapore
Matthias Yi Quan Liau, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
Igor A Kryvoruchko, Department of Surgery No. 2, Kharkiv National Medical University, Kharkiv 61022, Ukraine
Tamer AAM Habeeb, Department of General Surgery, Faculty of Medicine Zagazig University, Sharkia 44511, Egypt
Christopher Chia, Department of Gastroenterology, Woodlands General Hospital, Singapore 737628, Singapore
Vishal G Shelat, Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
Author contributions: Koo JGA, Liau MYQ, Kryvoruchko IA, Habeeb TAAM, Chia C, and Shelat VG conceptualized the paper, drafted the paper, and made critical revisions; Kryvoruchko IA, Habeeb TAAM, Chia C, and Shelat VG contributed the relevant clinical photos; All authors provided final approval of the version of the paper to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vishal G Shelat, FRCS, MBBS, MMed, Adjunct Associate Professor, Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. vishal_g_shelat@ttsh.com.sg
Received: March 8, 2024
Revised: May 19, 2024
Accepted: June 17, 2024
Published online: July 27, 2024
Processing time: 136 Days and 2.7 Hours
Abstract

A pancreatic pseudocyst is defined as an encapsulated fluid collection with a well-defined inflammatory wall with minimal or no necrosis. The diagnosis cannot be made prior to 4 wk after the onset of pancreatitis. The clinical presentation is often nonspecific, with abdominal pain being the most common symptom. If a diagnosis is suspected, contrast-enhanced computed tomography and/or magnetic resonance imaging are performed to confirm the diagnosis and assess the characteristics of the pseudocyst. Endoscopic ultrasound with cyst fluid analysis can be performed in cases of diagnostic uncertainty. Pseudocyst of the pancreas can lead to complications such as hemorrhage, infection, and rupture. The management of pancreatic pseudocysts depends on the presence of symptoms and the development of complications, such as biliary or gastric outlet obstruction. Management options include endoscopic or surgical drainage. The aim of this review was to summarize the current literature on pancreatic pseudocysts and discuss the evolution of the definitions, diagnosis, and management of this condition.

Keywords: Pancreatic pseudocyst; Pancreatic fluid collection; Cystic pancreatic lesions; Pancreatitis; Endoscopic ultrasound

Core Tip: Surgery was the mainstay of treatment for pancreatic pseudocysts in the past until other modalities such as endoscopic and percutaneous drainage emerged as viable alternatives. Endoscopic drainage is currently the preferred modality for drainage of pseudocysts unless indications for surgical intervention are present. Not all pancreatic pseudocysts require intervention, and most can be treated with supportive measures. Intervention is indicated if the patient is symptomatic or if complications are present.