We conducted a prospective analysis of our patients undergoing laparoscopic cystogastrostomy to analyse the merits and demerits of the procedure.
Laparoscopic cystogastrostomy is a safe and feasible method and provides efficient drainage of PP.
Moreover, as result of the thin cyst wall, internal drainage such as
cystogastrostomy or Roux-Y cystojejunumstomy was inappropriate which might give rise to a large number of complications such as anastomotic fistula, infection and cyst recurrence.
Two of the patients in this series were originally misdiagnosed elsewhere as having pseudocysts and underwent
cystogastrostomy.
This can either be done endoscopically using a flexible endoscope to establish a fistula between cyst and stomach or with laparotomy, gastroscope and
cystogastrostomy.
The endoscopic alternative to the transpapillary approach is transmural drainage, via
cystogastrostomy or cystoduodenostomy.
Other methods have since been developed, including PCD, endoscopic cystoenterostomy, and percutaneous
cystogastrostomy.
Five patients had pancreatic pseudocyst, successful
cystogastrostomy was done in four along with pancreatic sphincterotomy in three.
Skin Staples Skin Suturing Cholecystectomy 6 4
Cystogastrostomy 4 0 Intestinal Resection and 12 6 anastomosis Intussusception reduction 2 0 Appendectomy 10 22 Hydatid capitonnage 2 2 Splenectonomy 2 2 Anatomical repair of 6 8 umbilical hernia Adhesiosn release 4 4 Mesh repair of 2 2 Incisional hernia
5 Buchi et al reported endoscopic laser cystogastrostomy in 1986.
The end result is similar to surgical cystogastrostomy though with minimal trauma and morbidity.
of Surgical procedures patients Longitudinal Pancreatico-jejunostomy 27 Frey's procedure 15 Procedures for Pseudocyst
Cystogastrostomy 4 Cystojejunostomy 3 CT/USG guided aspiration 3 Laparomtomy+External drainage 1 Laparoscopic
Cystogastrostomy 3 Distal Pancreatectomy 3 Whipple's procedure 1 Cholecystectomy + LPJ 3 Laparoscopic Cholecystectomy 7
