However, cyst drainage was not adequate, and cystogastrostomy was revised to a Roux-en-Y cystojejunostomy
. A year later, the patient presented with obstructive jaundice for which he underwent hepaticojejunostomy.
Since 1960, spleen-preserving surgical techniques, such as partial splenectomy, enucleation, omenthoplasty, rederoofing, cystojejunostomy
, and internal or external drainage, have been suggested to protect against the drawbacks of total splenectomy (20,22).
2 patients of pancreatic malignancy underwent palliative anterior gastrojejunostomy and 2 patients underwent cystojejunostomy
for pseudopancreatic cyst (Table No.
Table 1 Drainage (i) Cystojejunostomy
options (ii) Laterolateral pancreaticojejunostomy (Partington-Rochelle procedure) (iii) Caudal drainage (Puestow procedure) Resection (i) Pancreaticoduodenectomy (PD/Kausch-Whipple procedure) or pylorus preserving pancreaticoduodenectomy (PPPD/Traverso-Longmire-procedure) (ii) Duodenum-preserving pancreatic head resection (DPPHR (Beger, Frey, Hamburg, Berne)) (iii) V-shaped excision (iv) Segmental resection (v) Distal/total pancreatectomy Neuroablative (i) Percutaneus radiofrequency procedure ablation of the splanchnic nerves (ii) Thoracoscopic splanchnicectomy
1b) are performed, and when a Roux-en-Y cystojejunostomy is performed (Fig.
Cystojejunostomy: Proposed by Pegulio & Pellisier in 1959, this consists of communication of the cyst cavity with a defunctionalized jejunal loop (Fig.
Laparoscopic Pancreatic Pseudocyst (PP) surgery can be performed via anterior or posterior cystogastrostomy, endoscopy-assisted surgery and cystojejunostomy. We conducted a prospective analysis of our patients undergoing laparoscopic cystogastrostomy to analyse the merits and demerits of the procedure.
Numerous techniques have been reported for laparoscopic PP surgery thus far, including anterior and posterior cystogastrostomies, endoscopy-assisted surgery and cystojejunostomy.8
anatomic variant promotes reflux of pancreatic juice into the common bile duct, resulting in inflamma-tion, weakening of the bile duct wall, and dilatation.10 Todani et al12 reported that patients with previous internal drainage developed cancer at a mean age of 35.6 years, approximately 10 years after cystojejunostomy
Eiver wedge biopsy and Roux in Y cystojejunostomy
Patients in the other studies underwent various procedures like ERCP with sphincterotomy, open and laparoscopic cholecystectomy, and pancreaticojejunostomy for pancreatic fistula, cystojejunostomy
for pseudocyst and open drainage for pancreatic abscess.
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