Harvitkar Rafique Umer, Bylapudi Seshu Kumar, Hannadjas Ioannis, Ren Jiahui, Balasubramanian Ashok, Tanveer Yousaf, Alam Yasir, Jhetam Tanwir, Gattupalli Giri Babu, Joshi Abhijit
General Surgery, Royal Sussex County Hospital, Brighton, GBR.
General Surgery, University Hospitals of Leicester NHS Trust, Leicester, GBR.
Cureus. 2025 Jun 21;17(6):e86476. doi: 10.7759/cureus.86476. eCollection 2025 Jun.
Introduction Pancreatic pseudocysts (PP) following pancreatitis pose a management challenge. Radiological and endoscopic methods may result in partial resolution or relapse and are chosen based on pseudocyst size, location, and anatomy. Minimally invasive approaches, particularly laparoscopic cystogastrostomy, are increasingly effective. The laparoscopic transgastric luminal cystogastrostomy technique facilitates complete necrosis debridement and internal drainage with minimal invasiveness. Materials and methods We retrospectively reviewed 25 symptomatic, radiologically confirmed patients who underwent laparoscopic cystogastrostomy between 2015 and 2024. Data collected included demographics, cyst characteristics, pancreatitis etiology, BMI, ASA grade, timing, operative details, complications, hospital stay, and return to normal activity. Short- and long-term outcomes were evaluated. Results The mean patient age was 55 years (range: 29-80), with 60% male. Gallstones caused PP in 60% of cases. Pseudocysts were located in the pancreatic body (60%) or head/neck (40%). Endoscopy failed in 60% and percutaneous drainage in 40% before surgery. The average BMI was 31 kg/m²; 56% were ASA grade 3. No conversions or perioperative mortalities occurred. The median interval from presentation to surgery was 79 days, with a mean operative time of 135 minutes and blood loss of 150 cc. ICU admission was required in 40% for a mean of 1 ± 0.5 days. The mean hospital stay was 5 ± 1 days. One patient had a procedure-related complication. At one month, 84% showed complete pseudocyst resolution; the rest resolved within four additional weeks. No recurrences, reoperations, or late complications were observed during a mean nine-month follow-up. Conclusion Laparoscopic cystogastrostomy offers a safe, effective, and cosmetically favorable option for PP management, with high resolution and no recurrences in our series.
引言 胰腺炎后胰腺假性囊肿（PP）的处理具有挑战性。放射学和内镜方法可能导致部分消退或复发，其选择基于假性囊肿的大小、位置和解剖结构。微创方法，尤其是腹腔镜囊肿胃吻合术，越来越有效。腹腔镜经胃腔内囊肿胃吻合术技术以最小的侵入性促进完全坏死清创和内引流。
材料与方法 我们回顾性分析了2015年至2024年间接受腹腔镜囊肿胃吻合术的25例有症状、经放射学证实的患者。收集的数据包括人口统计学资料、囊肿特征、胰腺炎病因、体重指数（BMI）、美国麻醉医师协会（ASA）分级、时间、手术细节（手术时间、出血量、ICU住院时间）、并发症、住院时间以及恢复正常活动情况。评估短期和长期结果。
结果 患者平均年龄为55岁（范围：29 - 80岁），60%为男性。60%的病例由胆结石导致PP。假性囊肿位于胰体部（60%）或头/颈部（40%）。术前60%的患者内镜治疗失败，40%的患者经皮引流失败。平均BMI为31kg/m²；56%为ASA 3级。无中转开腹或围手术期死亡病例。从出现症状到手术的中位间隔时间为79天，平均手术时间为135分钟，失血量为150cc。40%的患者需要入住ICU，平均入住时间为1±0.5天。平均住院时间为5±1天。1例患者出现与手术相关的并发症。1个月时，84%的患者假性囊肿完全消退；其余患者在接下来的4周内消退。在平均9个月的随访期间，未观察到复发、再次手术或晚期并发症。
结论 腹腔镜囊肿胃吻合术为PP的处理提供了一种安全、有效且美观的选择，在我们的系列研究中具有高消退率且无复发。
