Cyst : delayiing ERCP & operation?

[Guest guest]

Dear All,

My mother had accute Pancreatitis attack on 2nd Nov. 04. Since then she is

undergoing treatment from one GI. Little or slow improvement but no complele

improvement is observed. Hence she was shifted to Asian Institute of

Gastrointerology, Hyderabad. Now after @ 12 days admission Dr. says that the

Cyst has been formed consisting liquid and debris. So he advises to wait for

atleast one month and then operate for Gall Bladder removal after ERCP.

Whether cyst with debris is normal? Whether it gets cured? Shall we really wait?

Please advice.

-- S.S.Suryawamshi

Sangli, India

[Guest guest]

Dear Sadish,

What the doctor's are talking about is a pseudocyst. I have two of

them in my pancreas that I've had for almost four years. Pseudocysts

sometimes form on the inside or outside wall of the pancreas a few

weeks after a person has an acute pancreatitis attack. They are

comprised of liquid, enzyme, insulin and tissue debris collected from

the inflamation of the acute attack. They aren't that common, only

about 10% of the people who have acute pancreatitis attacks will form

pseudocyst(s).

After a pseudocyst has been discovered, it is the standard treatment

by most doctors to wait for at least one month to determine whether

the pseudocyst is going to increase in size, stay the same or reduce.

Under most circumstances, it is much safer to wait for this amount of

time so that the pseudocyst can finish it's development. The doctors

prefer that the pseudocyst become encapsulated within a thin wall

before they disturb it by performing drainage and/or surgery to remove

it. It could be dangerous to disturb the cyst before it has had time

to finish it's development, so typically, any invasive procedures are

postphoned until a later date. After the waiting period, if the

pseudocyst is not too large (usually less than 6 cm.), some doctors

prefer not to disturb it at all by drainage, they prefer to let it

rest and see if it will resolve (reduce) on its own. Surgery to

remove the pseudocyst is usually not considereded unless it is larger

than 6 cm., or if there are signs of infection.

Your mother's progress sounds about average. It takes many weeks to

fully recover from an acute pancreatitis attack, and the older a

person is, the recovery period is harder and longer than it would be

for a young person. I am 53, it took me more than 6 weeks to recover

from my last acute attack, and it was not as severe as your mother's was.

If you have any more questions about pseudocysts that you think I may

be able to answer, please post again. From the sounds of it, the

doctors at the Asian Institute of Gastroenterology are following all

the standard precautions and practices in dealing with pancreatitis

with pseudocysts. It sounds as though your mother is in good hands.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

South Carolina State Rep.

SE Regional Rep., PAI

http://pancassociation.org/anthology.htm#Heidi

Note: All comments or advice are based on personal experience or

opinion, and should not be substituted for consultation with a medical

professional.

> My mother had accute Pancreatitis attack on 2nd Nov. 04. Since then

she is undergoing treatment from one GI. Little or slow improvement

but no complele improvement is observed. Hence she was shifted to

Asian Institute of Gastrointerology, Hyderabad. Now after @ 12 days

admission Dr. says that the Cyst has been formed consisting liquid and

debris. So he advises to wait for atleast one month and then operate

for Gall Bladder removal after ERCP.

> Whether cyst with debris is normal? Whether it gets cured? Shall we

really wait? Please advice.

>

> -- S.S.Suryawamshi

> Sangli, India