Minimally Invasive Approach in the Management of Pancreatic Pseudocysts

Introduction The laparoscopic and endoscopic approaches to internal drainage of pancreatic pseudocysts are the current minimally invasive management options. Indications, early and late results of endoscopic and laparoscopic treatment options are being discussed. Aim To present experience in treatment of pancreatic pseudocyst by laparoscopic pseudocystogastrostomy and endoscopic pseudocystogastrostomy and to compare results, feasibility and safety. Materials and methods A retrospective analysis of minimally invasive pancreatic pseudocysts treatment was performed and patients were divided in two groups according to performed drainage procedure. First group - laparoscopic pseudocystogastrostomy, second–endoscopic pseudocystogastrostomy. Groups were compared by age, gender, pancreatic pseudocyst’s age, diameter and localization, as well as intraoperative, early and late postoperative complications. Results Sixty-three patients underwent surgical intervention: 14 patients–laparoscopic pseudocystogastrostomy (group I), 49–endoscopic pseudocystogastrostomy (group II). Average cyst diameter: group I–118.6±45.2 mm, group II–115.3±34.3 mm, p=0.8. Neither in group I nor in group II intraoperative complications occurred. Early minor complications: group I–3 (21.4%), group II–10 (20.4%), p=0.93. Early major complications: group I–0, group II–6 (12.2%), p=0.17. Late postoperative complications: group I–0, group II–1 (2%), p=0.59. In group I there was no case, whereas in group II there was 6 (12.2%) cases of cyst recurrence, p=0.32. Conclusions We have found that both methods to be feasible, effective and safe. Endoscopic treatment should be stated as the first choice treatment approach for patients with pancreatic pseudocyst and only then it fails, laparoscopic pseudocystogastrostomy should be performed.


Audrius Šileikis, Augustas Beiša, Mindaugas Kvietkauskas, Juozas Stanaitis, Aušra Aleknaitė, Kęstutis Strupas

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