IPEG 2020 TOP ABSTRACT: PSEUDOPANCREATIC CYST DRAINAGE WITH TRANSGASTRIC LAPAROSCOPIC CYSTOGASTROSTOMY
This video is for verified healthcare professionals.Sign in to watch — the rest of this page is open.Sign in
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
More about pancreatic pseudocyst
same diagnosisOnly a few other public items share this diagnosis — nothing to add yet.
What the experts said
The patient was a 6-year-old boy with pancreatic pseudocyst secondary to pancreatitis caused by severe blunt abdominal trauma from a bicycle handlebar.
On admission to the ER, the patient presented with abdominal pain, abdominal distention, and vomiting.
CT imaging showed a giant fluid collection between the pancreas and stomach.
The patient was positioned in modified Lloyd Davis position with the surgeon at the feet, assistants at both sides, and scrub nurse at the right side.
Ports were placed with 1 in the umbilicus and 2 on both flanks.
Two 12mm balloon trocars were inserted through the anterior gastric wall under vision of both endoscope and laparoscope while keeping the stomach insufflated.
A puncture on the posterior gastric wall was performed with a suction needle, followed by confirmation of cyst location.
Clear fluid was drained from the pseudocyst after the incision was enlarged with electrocautery.
A 45mm endoGIA stapler was used to create the cystogastrostomy.
Gastrotomies in the anterior gastric wall were closed with non-absorbable suture.
The surgery had a duration of 3 hours, including anesthesia time.
No second-look surgeries or interventions were needed.
The patient was admitted to the intermediate care unit after surgery.
Diet was well tolerated on postoperative day 4, and the patient was discharged the next day (postoperative day 5).
At 6-month follow-up, the patient was asymptomatic and abdominal ultrasound was normal.
Control upper gastrointestinal endoscopy at 6 months showed no pathological findings and normal continuity of the gastric wall.
Laparoscopic transgastric cystogastrostomy is a feasible alternative in pediatric patients with pancreatic pseudocyst, especially when there is a giant cyst.
The wider anastomosis created by this technique may minimize the need for repeat drainages.
The use of laparoscopic transgastric cystogastrostomy is safe in suitable pediatric cases.