Laparoscopic cystogastrostomy via the posterior approach for pancreatic pseudocyst drainage

The treatment of pancreatic pseudocysts is still being debated. Laparoscopic treatment of pancreatic pseudocysts enables definitive drainage with faster recovery. Moreover, the best drainage technique for pseudocysts located adjacent to the posterior gastric wall is pseudocystgastrostomy. Although, drainage via the anterior approach has been frequently reported, reports on the posterior approach are rare. Here, we evaluated the efficacy of the posterior approach technique for pancreatic pseudocyst drainage.

We retrospectively studied 28 patients who underwent cystogastrostomy for pancreatic pseudocysts: they were divided into the conventional cystogastrostomy group (CCG group) and the laparoscopic cystogastrostomy via the posterior approach group (LCGP group).

The mean operative time was significantly shorter, blood loss was significantly reduced, and the duration of hospitalization after surgery was significantly shorter in the LCGP group than in the CCG group. Recurrence was observed in 1 patient (5.6%) in the CGP group; it was an asymptomatic recurrence that did not require additional treatment. In contrast, there was no recurrence in the LCGP group patients.

We think that our technique of performing laparoscopic cystogastrosotmy via the posterior approach is easy and feasible for pancreatic pseudocyst drainage.