RESUMO
Pseudocysts of pancreas is collection of fluid in the lesser sac enclosed by a wall of fibrous or granulation tissue as a consequence of acute pancreatitis, pancreatic trauma or chronic pancreatitis. Invasive drainage procedures are currently indicated in those patients with symptoms or complications. We present our experience of 26 cases of pseudocyst of pancreas managed laparoscopically between Nov-2014 to March-2016 using different techniques of anastomosis using Vicryl 2-0 continues sutures as well as using Titanium clips for creating stoma between anterior wall of pancreatic pseudocyst and posterior wall of stomach. Laparoscopic cysto-gastrostomy appears to be safe and effective approach for internal drainage of pancreatic pseudocyst. It also facilitates the debridement of the necrotic tissue from the cyst cavity. Use of Titanium clips can be an alternative to conventional sutured cystogastrostomy and stapled cystogastrostomy, as it is less time consuming, easy to perform and cost effective
RESUMO
Objective To observe the outcome and consequential treatment during recovery of patients with severe acute pancreatitis (SAP) after non operative treatment.Methods The data of the follow up for 1 to 12 years in 41 cases of SAP with pseudocyst of pancreas, recurrent pancreatitis, chronic abdominal pain and gallbladder stones examined with CT, ERCP, laparotomy or pancreatic tissue biopsy from 3 months to 2 years were retrospectively analyzed. Results Pseudocyst of pancreas was the main complication of SAP after non operative treatment. The absorption of necrotic tissues of pancreas and proliferation of fibrotic tissue took a slow course of 3 to 6 months. The long term excellent curative rate was 73.2% and the rate of abdominal pain or maldigestion was 24 4%. One patient died of recurrent pancreatitis (2 4%). Conclusions More attention should be paid to treating pseudocyst of pancreas, resecting the gallbladder stones in time and preventing or treating recurrent pancreatitis after the recovery from SAP.