Cystojejunostomy-an ideal treatment for pancreatic pseudocyst located distant to the stomach

C Palanivelu, MS, MCh, FACS, P Sethilnathan, MS, R Parthasarathi, MS, P Praveen Raj, MS, Vp Nalankilli, MS, S Sumonth, MS. GEM Hospital & Research Centre, Coimbatore, INDIA.

Pancreatic Pseudocysts are a common sequelae of acute pancreatitis. It accounts for 75% of the cystic neoplasms of the pancreas. In case of symptomatic cysts, rapidly enlarging or complicated cysts , it should be treated surgically.
Cystojejunostomy is an option where the cyst is not in apposition of the stomach wall / duodenum and consequently cystogastrostomy / cystoduodenostomy is not an option.
Here we demonstrate a video of cystojejunostomy in a case of pancreatic pseudocyst

Patient Position- modified lithotomy position with legs split apart.
Surgeon Position- Stands in between the legs,Camera surgeon on left side,1st assistant on right side
Port Position- 5 mm port at Rt hypochondrium.
10 mm port above the umbilicus and Rt Hypochondrium.
Gastocolic ligament is divided (depending on cyst position).
Pseudocyst defined.
Roux-en-y jejunal loop is brought out through the mesenteric window and cystojejunostomy performed.
Window closed , Jejuno-jejunostomy done.
Laparoscopic cystojejunostomy is a good procedure for pancreatic pseudocysts not in apposition of stomach or the duodenum. It is safe,effective and allows patient an early resumption of their normal activities

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