Background
Cystogastrostomy is the most effective drainage method for large, persistent pancreatic pseudocyst (PP). There are many approaches for cystogastrostomy either open cystogastrostomy, laparoscopic cystogastrostomy (LCG), or nonsurgical techniques (endoscopic or percutaneous radiologic drainage).
Patients and methods
This was a prospective clinical trial single-center experience study on patients with PP who presented at our outpatient clinic at Ain Shams University hospitals during the period from January 2019 till January 2021. It included patients with symptomatic cyst of more than 6 cm with well-formed wall after 6 weeks from the last attack. The included cases underwent LCG, aiming to assess our early experience of LCG and its short-term outcome.
Results
A total of 20 patients with PP presented to us during the study period, and 16 (80%) patients met the inclusion criteria, and these patients underwent LCG. The mean operative time was 170.31 min, and the mean blood loss was 156.88 ml. Overall, 6.3% of our cases had open conversion. Concomitant cholecystectomy was done in 56.3% of our cases. The mean hospital stay was 6.31 days, with 12.5% of our cases had postoperative wound infection and 6.3% had postoperative hematemesis. No cases of recurrence or mortality were encountered in our study.
Conclusion
Laparoscopic drainage of PP has major advantages over the open approach in the form of less postoperative pain, hospital stay, and wound complications with comparable recurrence incidence. Our early experience in laparoscopic anterior cystogastrostomy approach was promising with good results and acceptable morbidity, which encouraged us to expand this approach in drainage of PP.