Laparoscopic management of pancreatic pseudocyst: a prospective study

Abstract

Background: Pancreatic pseudocysts can be defined as localized fluid collections that have a nonepithelialized wall consisting of fibrous and granulation tissue. These pseudocysts usually appear several weeks after the onset of pancreatitis. Advancement in the management of pseudocyst with laparoscopic drainage provides a good alternative or supplement to the surgical treatment of pancreatic pseudocyst. The purpose of this study is to evaluate the feasibility, effectiveness and outcome of Laparoscopic drainage.Methods: It was a prospective interventional hospital based study carried out among 32 indoor cases of pancreatic pseudocysts operated using laparoscopic procedures admitted under department of general surgery in a tertiary healthcare teaching institute during study period. Cases of pancreatic pseudocysts were evaluated with detailed history, clinical signs and symptoms, the duration and investigations. Details of laparoscopic, its indications, peculiarities, complications rates, recurrence rate and outcome was analyzed.Results: Single and multiple pancreatic pseudocysts were found in 26 (81.25%) and 6 (18.75%) patients and the most common site was found to be body of pancreas (59.37%). Obstructive jaundice (18.50%) and gastric outlet obstruction (15.63%) were the most common complications seen. The common procedures undertaken in the studied cases were laparoscopic cystogastrostomy (65.62%) followed by laparoscopic cystojejunostomy (12.50%) and laparoscopic external drainage (12.50%). Common complications in studied cases were found to be pain (15.65%), fever (12.5%) and external fistula (6.25%).Conclusions: Laparoscopic technique for treatment of pancreatic pseudocysts is safe, efficacious, feasible and is associated with fast recovery. These techniques should be preferred over open surgical drainage.