What is All of the following statements about pseudopancreatic cysts are true except and explain in detail?
Treatment of Pancreatic pseudocyst Pseudocyst 5 cm in diameter and <6 weeks old should be observed, as they tend to resolve spontaneously Pseudocyst >5cm diameter is an indications for drainage If infection is suspected, the pseudocyst should be aspirated (not drained) by CT - or US - guided FNA, and the contents examined for organisms by Gran stain and culture If infection is present, and the contents resemble pus, external drainage is employed, using either surgical or percutaneous techniques Pseudocysts communicate with the pancreatic ductal system in upto 80% of cases, so external drainage creates a pathway for pancreatic duct leakage to and through the catheter exit site Methods of internal drainage Percutaneous catheter based methods (transgastruc puncture and stent placement to create a cystogastrostomy) Endoscopic methods (transgastric or Transduodenal puncture and multiple stent placements with or without a nasocystic irrigation catheter) Surgical methods (a true cystoenterostomy, biopsy of cyst wall, evacuation of all debris and contents) Surgical options : Cystogastrostomy, Roux-en-Y cystojejunostomy, cystoduodenostomy Preferred modality : Internal drainage of cyst by cystojejunostomy Ref: Sabiston 20th edition Pgno :1534-1535