Laparoscopic Cystogastrostomy in Pancreatic Pseudocysts: A case report

Min, Seog Ki; Kim, Young Woo; Han, Ho Seong; Choi, Yong Man

Abstract

Laparoscopic surgery on the pancreas is carefully attempted because the pancreas is a retroperitoneal organ and because the tissue is very fragile and composed of abundant small vessels. Recently, the authors experienced one case of a laparoscopic cystogastrostomy for a pancreatic pseudocyst. The patient was a 43-year-old man and a chronic alcoholic. He visited the emergency room for severe abdominal pain which had lasted for 2 weeks. Ultrasonography revealed a huge pseudocyst in the retroperitoneum. The size of the pseudocyst was 10 cm 9 cm, and it was located at the pancreatic tail in the abdominal CT. Through four 10 mm ports, the gastric anterior wall was longitudinally incised about 4 cm; then, a communicating window between the stomach and the pseudocyst was made with endoscopic cautery after using needle aspiration to recognize the cyst. The pseudocyst was completely gone in the follow up CT, and the man was discharged without complication on the postoperative 10 th day. The laparo scopic cystogastrostomy is not only a feasible operation but also a minimally invasive and effective method for treating huge, maturated pancreatic pseudocysts.