P Senthilnathan, R Parthasarathi, S Rajapandian, P Praveen Raj, Anand Vijai, V P Nalankilli, G Srivatsan, Sandeep Sabnis, C Palanivelu. GEM Hospital & Research Centre
BACKGROUND: Management of pancreatic pseudocyst (PPC) has gone through major changes from open to laparoscopic and then to endoscopic internal drainage. PPC which are amenable for cystogastrostomy (by virtue of their location) are being managed in increasing numbers by endoscopic methods and those in other locations are still managed by surgical methods mainly by jejunal drainage.
Data of period I has already been published. Of 82 cases in period II, 14 cases were managed by endoscopic internal drainage which were excluded. Remaining 68 cases(period II) were considered for analysis.
Laparoscopic cystogastrostomy (LCG) was done in 42 cases (61.7%), and laparoscopic cystojejunostomy (LCJ) in 19 cases (27.9%), laparoscopic external drainage in 5 cases(7.3%).The mean operating time was 118 minutes in LCG group and 150 min in LCJ group.
All the cases were successfully operated without any significant intraoperative complications. Intra operataive blood loss was <50ml. There were no conversions to open surgery. Mean hospital stay was 5.5 days.
METHODS: Patients who underwent intervention for PPC at our centre from 1994 to August 2015 were divided into two time periods. Period I(1994-2006) and period II(2007- 2015). Data of two groups was analysed from a prospectively maintained data base.
RESULTS: There were a total of 190 patients who were offered intervention for pseudocyst of pancreas between 1994 to 2015. Period I had a total of 108 patients and Period II has 82 patients. We had post op complications in 3 patients in LCG group- two bleed and one leak. We had recurrence in 1 patient and no mortality. In our previous series, between 1994-2006, of the total 108 cases, LCG was done in 90 cases (83.4%) and LCJ was done in 8 cases (7.4%).
CONCLUSION: Our experience in two different time period showed that there is increasing proportion of Laparoscopic Cysto-Jejunostomy being done now, which requires more advanced laparoscopic skills then Cysto-Gastrostomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80843
Program Number: P443
Presentation Session: Poster (Non CME)
Presentation Type: Poster
