Pancreatic pseudocyst: the controversial value of total parenteral nutrition.

Abstract

BACKGROUND/AIMS:

Total parenteral nutrition (TPN) for the non-operative treatment of acute pancreatic pseudocyst has been of hypothetical benefit.

MATERIALS AND METHODS:

We reviewed pseudocyst hospital admissions in 40 patients treated with TPN who had serial imaging studies. The mean cyst size was 7.4 cm on presentation, decreasing to 5.6 cm after non-operative treatment with TPN (mean 32.5 days).

RESULTS:

After a non-operative period, 68 percent of pseudocysts regressed, completely in 14 percent, partially in 54 percent. Except for a patient with cyst-related obstructive jaundice, there were no complicated pseudocysts. Only 12 (28%) patients underwent cyst drainage. Fifteen patients (35%) sustained catheter-related complication, which included sepsis (26%), pneumothorax (9%), hydropneumothorax (2%), and septic right atrial thrombosis (2%), in the course of hospitalisation.

CONCLUSION:

The majority of TPN-related patients had a clinical and radiographic regression of their pseudocysts. However, the increased risk of catheter-related complications in this group suggests that this therapy should be limited to patients who are unable to sustain enteral nutrition.

• Authors: M D Shahrudin, S M Noori
• Journal: Hepato-gastroenterology (Hepatogastroenterology) 1997 Mar-Apr Vol. 44 Issue 14 Pg. 559-63 ISSN: 0172-6390 [Print] Greece
• PMID: 9164537 (Publication Type: Journal Article)

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Catheterization, Central Venous (adverse effects, instrumentation)
• Catheters, Indwelling (adverse effects)
• Cholestasis (etiology)
• Drainage
• Female
• Follow-Up Studies
• Heart Atria
• Heart Diseases (etiology)
• Humans
• Hydropneumothorax (etiology)
• Male
• Middle Aged
• Pancreatic Pseudocyst (complications, diagnostic imaging, therapy)
• Parenteral Nutrition, Total (adverse effects, instrumentation)
• Patient Admission
• Pneumothorax (etiology)
• Remission Induction
• Retrospective Studies
• Sepsis (etiology)
• Thrombosis (etiology)
• Tomography, X-Ray Computed
• Treatment Outcome
• Ultrasonography