Ionut Bogdan I Diaconescu, MD, PhD, Matei Razvan Bratu, Madalina Ilie, Gabriel Constantinescu, Mircea Beuran. Carol Davila University of Medicine and Pharmacy
Introduction: Laparoscopic cystogastrostomy is an suitable procedure for the drainage of pancreatic pseudocysts if the cysts is present in the lesser sac (retro-gastric).
Methods: We present a series of 7 consecutive cases. First option was endoscopic transmural drainage like an ideal procedure. It was tried, but for two cases it failed, because the cyst wall was thick and the cyst had completely compressed the stomach, making endoscopic manipulation difficult inside the stomach.
Results: For 5 cases Endoscopic drainage was the only procedures. Laparoscopic drainage was a simple solutions to the problems in managing a huge pancreatic pseudocyst of 17 cm×18 cm in a 57 years old male with a history of acute pancreatitis. Ultrasound and computed tomography revealed showed a walled off cystic collection that pushed the stomach superiorly. The cyst was exposed by dissecting the lesser omentum and found to have no adhesion to the surrounding tissues. Anastomosis was performed using an endoscopic linear stapler via small cystotomy and gastrotomy openings on the lesser curvature, which were then sutured laparoscopically. The postoperative course was uneventful.
Conclusion: Laparoscopic surgery is recommended as a safe, reliable, and minimally invasive treatment for managing pancreatic pseudocyst. Both techniques are suitable but with different indications that should be adapted to the case.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 96032
Program Number: P236
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster