Minimally invasive open cystgastrostomy for pancreatic pseudocyst

One of the complications of pancreatitis is pancreatic pseudocyst. Many different techniques have been described for internal drainage of pancreatic pseudocyst. Indication for surgery is either symptomatic or large cysts that can turn into complications such as hemorrhage, obstruction, infection, rupture and malignancy. Our technique includes an incision between 5 cm to 9 cm below the left subcostal margin and the opening of the anterior stomach and a posterior cystgastrostomy performed with a reticulated laparoscopic staple. We have been able to perform surgery in a very large pseudocyst (up to 26 cm) in a small amount of time, within 45 min, and with a shorter length of hospital stay (36 h). In this paper, we present our technique on how to approach large pseudocysts utilizing a minimally invasive small incision.