<bold>The aim of the study</bold> was to determine the optimal surgical strategy in patients with pancreatic tail cysts infiltrating the spleen, stomach, left diaphragmatic dome, or transverse colon mesentery.
<bold>Material and methods.</bold> From 1997 through 2004, 184 patients with pancreatic pseudocysts were evaluated and treated in our Department. In 63 of those cases (34.2%), the lesion was located in the tail of the pancreas, and was classified as type II or III according to D. Egidio and Schein.
<bold>Results.</bold> Combined pancreatic tail and splenic resection was performed in 32 subjects (51%), 13 (20%) underwent external drainage / marsupialisation, 11 (18%) had a Roux-en-Y pancreaticocystojejunostomy, and one patient underwent a Duval operation. Endoscopic drainage to the stomach (pancreatocysto-gastrostomy) was used in one subject; another five patients who had previously undergone external drainage / marsupialisation and developed a recurrent cyst within four months after the primary procedure were selected for pancreaticocystojejunostomy. Thus, internal drainage was performed in a total of 18 patients (28%).
<bold>Conclusions.</bold> Based on our experience, we prefer pancreatic tail resection (with splenectomy) in those patients who present to the hospital with involvement of the neighbouring organs.
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