Laparoscopic Roux-En-Y Pancreatic Cystojejunostomy for Two Symptomatic Pseudocysts

Abel E Bello, MD, Dennis Orr II, DO. Western Reserve Health Education

Pancreatic pseudocysts are usually managed conservatively as many of these resolve without intervention. When these collections develop symptoms or complications, usually require treatment. Multiple modalities of drainage have been proposed including endoscopic, percutaneous or surgical internal drainage with variable success in selected patients. Surgical drainage still remains the gold-standard. These can be performed via a cystgastrostomy or cystenterostomy either with a laparoscopic or open approach. Pseudocysts that are not in close proximity to the stomach require a cystojejunostomy. The operative treatment of one pseudocyst may be challenging. The treatment of two becomes even more complex. We present a patient with two pancreatic pseudocysts, one in the head and one in the tail of the pancreas accompanied by pain, jaundice, pruritus and early satiety who was managed satisfactorily with a Laparoscopic Roux-en-Y cystojejunostomy of both cysts with very good clinical outcome.

Current available resources are lacking demonstration of a laparoscopic surgical drainage technique in this setting.

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