Laparoscopic Cystogastrostomy for the Patient of Pancreatic Pseudocyst with Intra-abdominal Adhesion

ABSTRACT

A large symptomatic and unresolved pancreatic pseudocyst is treated surgically by internal drainage to a neighboring adherent viscus. Recently the various minimal invasive approaches have been used to treat this condition. A 30- year-old man who had been in clinical follow-up for a chronic pancreatitis. For the necrotizing pancreatitis, the patient had undergone surgical debridement and external drainage 5 years, and 3 years ago, respectively. Abdominal ultrasonography and computed tomography revealed 8.2x7.7 cm sized pseudocyst in the body of pancreas. Endoscopic internal fistula formation was tried, but it was failed due to bleeding. We underwent adhesiotomy and cystogastrostomy totally with laparoscopic techniques. The patient started a diet on the 5th postoperative day and discharged on the 11th postoperative day. There was no postoperative complicationand no recurrence during 6 months. Laparoscopic cystogastrostomy is safe and feasible method in the pancreatic pseudocyst even in case of severe abdominal adhesion.