Minimally invasive management of pancreatic pseudocysts

INTRODUCTION: The laparoscopic and endoscopic approaches to internal drainage of pancreatic pseudocysts (PP) are the current minimally invasive management options. Indications, and early and late results of endoscopic and laparoscopic approaches are being discussed. AIM: To present experience in treatment of PP by laparoscopic pseudocystogastrostomy (LPGS) and endoscopic pseudocystogastrostomy (EPGS) and to compare results, feasibility and safety. MATERIAL AND METHODS: Thirty patients underwent surgical intervention: 18 patients – LPGS (group I), 12 – EPGS (group II). Groups were compared by age, gender, pancreatic pseudocysts’s age, diameter and localization, as well as intraoperative, early and late postoperative complications. RESULTS: Gender distribution, group I: 14 (77.8%) men and 4 (22.2%) women, group II: 4 (33.3%) men and 8 (66.7%) women, p = 0.02. Average cyst diameter: group I – 149.9 ±52.1 mm, group II – 119 ±37.9 mm, p = 0.07. Average time between diagnosis and operation performance: group I – 12 (3-60) months, group II – 8 (2-36) months, p = 0.19. Neither in group I nor in group II did intraoperative complications occur. Early postoperative complications were divided into minor and major. Early minor complications: group I – 2 (11.1%), group II – 0, p = 0.5. Early major complications: group I – 0, group II – 2 (16.7%), p = 0.15. Late postoperative complications: group I – 0, group II – 1 (8.3%), p = 0.4. In group I there was no case, whereas in II group there was 1 (8.3%) case of recidivation, p = 0.4. CONCLUSIONS: For selected patients both minimally invasive methods are equally safe an effective. For comprehensive evaluation of methods prospective trials are needed.