We reviewed our experience with 120 patients presenting with pancreatic pseudocysts over a 13-year period, comparing management and outcome prior to (n = 45) and after (n = 75) the more general use of CT scan. We found that despite the more frequent use of CT scan for diagnosis, patient presentation and morbidity and mortality associated with pseudocysts has not changed. Management of chronic pseudocysts and acute pseudocysts less than 5 cm has not changed. However, acute pseudocysts larger than 5 cm are more frequently managed by observation alone with intervention reserved for cysts present for longer than 6 weeks, cysts associated with severe symptoms, or a suspicion of cyst-related complications. In addition, due to the risk of complication or failure we reserve percutaneous drainage for a specific group of patients.
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