ABSTRACT

There is a well-defined subset of patients with acute pancreatitis who will develop local complications including necrosis, infection, or peripancreatic fluid collections that prompt a surgical referral. It is critical for the surgeon to have a thorough understanding of this disease process and a well-developed algorithm to select from the myriad of available diagnostic and interventional options. Pancreatic pseudocysts (PS) is diagnosed as a persistent mature fluid collection in association with interstitial edematous pancreatitis. Most importantly, the term “pseudocyst” should not be utilized in necrotizing pancreatitis-associated fluid collections, which are termed “walled off necrosis”. Abdominal radiologic imaging with CT and/or MRI has become the standard for evaluating the patient with a known or suspected PS and for surveilling patients to determine resolution versus persistence. Advanced endoscopic interventions have been among the most important advances in treating large or symptomatic PS and have largely supplanted surgery.