Laparoscopic pancreatic cystgastrostomy |
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Authors: | Mori Toshiyuki Abe Nobutsugu Sugiyama Masanori Atomi Yutaka |
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Institution: | (1) Department of Surgery I, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan, JP |
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Abstract: | Background/Purpose: Internal drainage of acute pancreatic pseudocysts is indicated after the first 6 weeks of pseudocyst documentation. It is
also indicated for symptomatic chronic pseudocysts 6 cm or more in diameter. When a pseudocyst is in close contact with the
posterior wall of the stomach, it is best drained by pseudocyst gastrostomy.
Methods: Intragastric surgical techniques were used in 18 patients with retrogastric pseudocysts. Intragastric ports were successfully
placed in all patients, and the presence of pseudocysts was confirmed by needle aspiration in 17.
Results: The intragastric approach was successful in 14 patients. In three cases a small abdominal would 8 cm in length was needed.
The reasons for such conversion included uncontrollable bleeding from the cystic wall in two cases and a cystic wall in contact
with, but not adherent to, the posterior gastric wall in one. Bleeding was controlled through a gastrotomy, and cystgastrostomy
was performed. The wound required for conversion was much smaller than that needed for planned open surgery. These procedures
are called laparoscopy-assisted cystgastrostomy. Good short- and long-term results were obtained. One patient, in whom the
cystgastrostomy was too small, developed a cyst infection and underwent reoperation. Except for this case, no recurrence was
observed, and no further treatment was needed.
Conclusions: This experience demonstrates that cystgastrostomy with the intragastric surgical technique is a safe, less invasive procedure
for effectively draining a retrogastric pseudocyst.
Received: April 20, 2002 / Accepted: May 13, 2002
Offprint requests to: T. Mori |
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Keywords: | Pancreatic pseudocyst Lapar oscopic surgery Intragastric surgery Pancreatic pseudocyst gastrostomy |
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