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Laparoscopic versus open cystgastrostomy for pancreatic pseudocysts: a case-matched comparative study
Yazan S Khaled1, Deep J Malde, Jessica Packer
1Hepato-Pancreato-Biliary Unit, North Manchester General Hospital, Delaunays Road, Crumpsall, Manchester, M8 5RB, UK; The University of Manchester, Manchester, UK.
Journal of Hepato-Biliary-Pancreatic Sciences
|August 2, 2014
Summary
Laparoscopic cystgastrostomy for pancreatic pseudocysts offers a shorter operating time and faster recovery compared to open surgery. This minimally invasive approach leads to reduced morbidity and hospital stays, making it a preferred option when expertise is available.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Cystgastrostomy is the standard for draining pancreatic pseudocysts (PPs).
- Laparoscopic cystgastrostomy (LCG) is suitable for large, retrogastric PPs, but its advantages over open surgery (OCG) require demonstration.
Purpose of the Study:
- To compare the outcomes of laparoscopic versus open cystgastrostomy for pancreatic pseudocysts.
Main Methods:
- A 3:1 matched cohort study comparing LCG and OCG patients based on age, sex, and pseudocyst size.
- Outcomes were analyzed on an intention-to-treat basis, with data presented as medians.
Main Results:
- The study included 40 matched patients (30 LCG, 10 OCG).
- LCG demonstrated significantly shorter operating times (62 vs. 95 min, P=0.035) and lower postoperative morbidity (10% vs. 60%, P=0.024).
- LCG also resulted in a shorter hospital stay (6.2 vs. 11 days, P=0.038), with one operative death in the OCG group.
Conclusions:
- Laparoscopic cystgastrostomy for large pancreatic pseudocysts offers advantages over open surgery.
- These benefits include reduced operating time, quicker recovery, and shorter hospital stays.
- The laparoscopic approach is recommended where surgical expertise is available.
