Laparoscopic Cystogastrostomy for Pancreatic Pseudocyst – Our Experience.

Manash Ranjan Sahoo, MS, Anil Kumar T, POST, GRADUATE

SCB MEDICAL COLLEGE, CUTTACK, ODISHA, INDIA

AIMS AND OBJECTIVES: To demonstrate that laparoscopic cystogastrostomy is an ideal procedure for pancreatic pseudocyst.

MATERIALS AND METHODS: Pancreatic pseudocyst is one of the sequelae of acute pancreatitis. In our hospital we have performed 15 laparoscopic cystogastrostomies over a period of 5 years (July 2007 to July 2012). Laparoscopically, by a 3 port approach, gastrotomy was done on the anterior wall of the stomach. The prominent part of the posterior wall was then aspirated with LP needle and presence of cyst was confirmed by presence of dark coloured fluid. Then stay sutures were taken on the posterior wall and entry made with harmonic scalpel. Cyst contents were aspirated and the opening was enlarged to 5-6 cm with the help of harmonic scalpel. Debris were removed, cyst was cleaned with saline. Margin of the opening was sutured with 2-0 prolene. Then the anterior wall of the stomach was closed with vicryl in double layers and tube drain was placed in peritoneal cavity. The mean size of the pancreatic pseudocyst was about 10 X 8 cm. Patients were selected in whom cysts were present in the body of Pancreas. Mean duration of operation was about 1.5 hours. The mean duration of hospital stay was 3 days. The patients were routinely followed up with a repeat USG for a minimum period of eight months.

RESULTS: All patients had very good recovery with postoperative follow up uneventful.

CONCLUSION: Laparoscopic cystogastrostomy is a safe, feasible and effective procedure for pancreatic pseudocyst with minimal morbidity.

Session: Poster Presentation

Program Number: P315