engleski

Laparoscopic cystogastrostomy for pancreatic pseudocysts

INTRODUCTION: Pancreatic pseudocyst is one of the most common complications of acute pancreatitis. Symptomatic or complicated pseudocysts require treatment which could be the best accomplished by internal drainage. The standard method for internal drainage is open surgery but in recent years several methods of laparoscopic approach have been reported. Here we present our first four cases of laparoscopic internal drainage of pancreatic pseudocyst established by creating cystogastrostomy. PATIENTS AND METHODS: Four patients, two males and two females were operated due to symptomatic pseudocysts after acute necrotic biliary pancreatitis. In all cases, laparoscopic transgastric cystogastrostomy and simultaneous cholecystectomy was carried out. RESULTS: Mean operative time was 150 min. There were no conversions or postoperative complications. Postoperative follow-up ranging from 6 months to 18 months revealed no late complications. In the same period, using imaging studies of the upper abdomen, we didn't note any recurrences. CONCLUSION: Our initial results with laparoscopic internal drainage of pancreatic pseudocysts are encouraging, although due to the small number of cases no definitive recommendation can be made. This procedure can be performed through trocar incisions only, thereby completely avoiding laparotomy. By inserting laparoscope into the pseudocyst cavity, optimal visualisation and removal of necrotic tissues can be performed, which can ensure the same therapeutic efficacy as with open surgical internal drainage.

laparoscopic cystogastrostomy; pancreatic pseudocyst

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