Differentiated Surgical Management of Post-Necrotic Pancreatic Cysts Based on Morphological Phase, Safe Access, and Healing Prognosis

The aim of the study was to evaluate the effectiveness of a differentiated surgical approach to the treatment of post-necrotic pancreatic cysts, taking into account the morphological phase of capsule formation, the presence of a safe puncture access (“acoustic window”), and the prognosis for healing of the cyst cavity. A retrospective single-center comparative study included 84 patients with post-necrotic pancreatic cysts: 36 in the control group and 48 in the main group. In the main group, the probability of completing treatment by a minimally invasive method was 75.0% versus 47.2% in the control group (RR 1.59; 95% CI 1.08–2.32; p=0.015), and the rate of open surgery decreased from 52.8% to 25.0% (RR 0.47; 95% CI 0.27–0.85; p=0.012). No cases of inadequate cavity debridement were observed in the main group. The results confirm the effectiveness of the proposed approach.