Laparoscopic Cystogastrostomy: The Way Forward In Management of Pseusodocyst of Pancreas

Lokesh M N; Dileep Ramesh Hoysal; Dr Satish V

Volume : VII, Issue : IX, September - 2018

Laparoscopic Cystogastrostomy: The Way Forward In Management of Pseusodocyst of Pancreas

Lokesh M N, Dileep Ramesh Hoysal, Dr Satish V

Abstract :

Pseudocyst of pancreas account for 75% of cystic lesions of the pancreas. Most resolve spontaneously but up to 10% can cause serious complications. Invasive methods are required in management of symptomatic pseudocyst of pancreas. Current treatment options include open, laparoscopic and endoscopic internal drainage. While minimally invasive methods are rapidly gaining over open approach, superiority of one method over anotherneed to be established.

Aim:To compare Laparoscopic vs. open internal drainage of Pseudocyst of Pancreas in our hospital in terms of efficacy, morbidity and mortality.

Methods:A total of 45 patients admitted to our tertiary care hospital during May 2013 to December 2017, were divided into opencystogastrostomy (OCG) and laparoscopiccystogastrostomy groups (LCG) and treated with intent to cure. Data was collected prospectively regarding operative efficacy, postoperative outcome, morbidity and mortality.

Results:22 patients underwent LCG and 23 patients underwent OCG. Mean operative time was similar in both groups without any significant intraoperative morbidity. One patient was converted due to dense adhesions. Postoperative pain, diet resumption and functional index was superior in comparison to open method(82% vs. 18.8%, POD2 vs. POD3 and 68% vs. 12.5% respectively) achieving statistical significance (P <0.05). Duration of hospital stay was significantly shorter in LCG vs. OCG(4.8 vs. 8.6 days). 9% of patients had early complications in open group. No postoperative mortality or late complications in both groups was noted during mean follow up of 11 months.

Conclusions:Based on the results obtained, it can be safely assumed that in management of pancreaticpseudocysts, laparoscopic approach should be one of the first option in suitable patients and with a skilled surgeon in terms of efficacy, safety and lesser complications.