Laparoscopic cysto-gastrostomy for management of pancreatic pseudocyst. Single center experience in upper Egypt

Authors

  • Wael Barakaat Ahmed Mohamed Department of Surgery, Sohag Medical School Sohag, Egypt
  • Magdy Khalil Abdelmageed Department of Surgery, Sohag Medical School Sohag, Egypt
  • Emad Gomaa Department of Surgery, Sohag Medical School Sohag, Egypt

DOI:

https://doi.org/10.18203/2349-2902.isj20172758

Keywords:

Anterior cystogastrostomy, Laparoscopic cystogastrostomy, Pancreatic pseudocyst

Abstract

Background: One of the most common lumps of the pancreas is the pancreatic pseudocyst, with an estimated incidence of 70-80%. There are two main options for treatment pancreatic pseudocyst if it persists beyond six weeks and not respond to conservative treatment, surgical (laparoscopic and conventional open surgery) and non-surgical treatment (endoscopic and percutaneous drainage through ultrasonography or computed tomography guide). The objective of this study was to evaluate the outcome of laparoscopic pancreatic cystogastrostomy for pancreatic pseudocyst as regard operative and postoperative results in Sohag university Hospitals.

Methods: This was a prospective observational single center study at the General surgery department Sohag University Hospitals, Egypt. The study populations were patients suffering from pancreatic pseudocyst attend to the outpatient clinic from March 2014 to March 2017. All patients were evaluated by history taking, physical examination, laboratory investigation and imaging evaluation by abdominal ultrasonography and contrast enhanced computed tomography of the abdomen.

Results: Between March 2014 and March 2017, 14 patients with pancreatic pseudocyst had fulfilled our inclusion criteria and included in this study. 8 patients were female and 6 patients were male. 12 patients had previous history of acute biliary pancreatitis at least 6 months before the operation. 2 patient had undetermined pancreatitis. The mean age of the patient was 45.5±1.8 years and the mean operative time was 153±29 minutes the mean time to start oral fluid was 29±2 hours. 12 of the patient shad a laparoscopic cholecystectomy as all of them had acute biliary pancreatitis all operations were completed laparoscopically no conversion to open surgery was done.no mortality detected in our study .no intraoperative complications only one case had postoperative bleeding that respond to conservative therapy, one case of postoperative wound infection responds to antibiotic therapy. All cysts were resolved completely success rate (100%). The mean hospital stay was 4.35±0.28 days. The mean follows up time was 10.5±0.875 months.

Conclusions: Laparoscopic cysogastrotomy is as safe, effective procedure for management of the pancreatic pseudocyst in the hand of expert well trained laparoscopic with enough equipment.

Author Biographies

Wael Barakaat Ahmed Mohamed, Department of Surgery, Sohag Medical School Sohag, Egypt

General Surgery

Magdy Khalil Abdelmageed, Department of Surgery, Sohag Medical School Sohag, Egypt

General Surgery Department

Emad Gomaa, Department of Surgery, Sohag Medical School Sohag, Egypt

General Surgery Department

References

Aljarabah M, Ammori BJ. Laparoscopic and endoscopic approaches for drainage of pancreatic pseudocysts: a systematic review of published series. Surg Endoscop. 2007;21(11):1936-44.

Palanivelu C, Senthilkumar K, Madhankumar MV, Rajan PS, Shetty AR, Jani K, Rangarajan M, Maheshkumaar GS. Management of pancreatic pseudocyst in the era of laparoscopic surgery-experience from a tertiary center. Surg Endoscop. 2007;21(12):2262-7.

Melman L, Azar R, Beddow K. Primary and overall success rates for clinical outcomes after laparoscopic, endoscopic, and open pancreatic cystogastrostomy for pancreatic pseudocysts. Surg Endosc. 2009;23:267-71.

Behrns KE, Ben-David K. Surgical therapy of pancreatic pseudo-cysts. J Gastrointest Surg. 2008;12:2231.

Gumaste V, Pitchumoni CS. Pancreatic pseudocyst. Gastroenterol. 1996;43:3-43.

Nema A. Laparoscopic drainage procedures for pancreatic pseudocyst: a review article. World J Laparoscop Surg. 2009;2(2):37-41.

Yang CC, Shin JS, Liu YT, Yueh SK, Chou DA. Management of pancreatic pseudocysts by endoscopic cystogastrostomy. J Formosan Med Asso. 1999;98(4):283-6.

Morino M, Garrone C, Locatelli C. Laparoscopic management of benign pancreatic cystic lesions. Surg Endosc. 1995;9:625.

Park A, Scwartz R. Laparoscopic pancreatic surgery. Am J Surg. 1999;177:158-63.

Aranha GV, Prinz RA, Freeark RJ, Kruss DM, Greenlee HB. Evaluation of therapeutic options for pancreatic pseudocysts. Arch Surg. 1982;117:717-21.

Melman L, Azar R, Beddow K, Brunt LM, Halpin VJ, Eagon JC, et al. Primary and overall success rates for clinical outcomes after laparoscopic, endoscopic, and open pancreatic cystgastrostomy for pancreatic pseudocysts. Surg Endosc. 2009;23:267-71.

Alkohaji AS, Alsawidan MA, Al-Mofleh OA, Pancreatic pseudocyst, surgical procedures outcomes: overview. Int J Healthcare Sci. 2016;4:1673-8.

Cuschieri SA, Jakimowicz JJ, Stultiens G. Laparoscopic in fracolic approach for complications of acute pancreatitis. Semin Laparosc Surg. 1998;5:189-94.

Chowbey PK, Soni V, Sharma A, Khullar R, Baijal M, Vashistha A. Laparoscopic intragastrical stapled cystogastrostomy for pancreatic pseudocyst. J Laparoendosc Adv. Surg Tech A. 2001;11:201-5.

Ramachandran CS, Goel D, Arora V, Kumar M. Gastroscopic-assisted laparoscopic cystogastrostomy in the management of pseudocysts of the pancreas. Surg Laparosc Endosc Percutan Tech. 2002;12:433-6.

Palanivelu C, Senthilkumar K, Madhankumar MV, Rajan PS, Shetty AR, Jani K, et al. Management of pancreatic pseudocyst in the era of laparoscopic surgery-experience from a tertiary center. Surg Endosc. 2007;21:2262-7.

Downloads

Published

2017-06-22

Issue

Section

Original Research Articles