ABSTRACT

Pancreatic pseudocyst is the commonest cystic lesion of the pancreas. When interference is indicated, open surgical therapy is the standard therapy with which other therapeutic modalities should be compared. Recently, endoscopic and laparoscopic approaches were reported for management of these cases. We aimed at exploring the minimally invasive techniques in treatment of pancreatic pseudocysts, namely endoscopic and laparoscopic, and comparing them to the open surgical therapy. Thirteen patients with pancreatic pseudocysts, for which interference was indicated, were included in this study. Seven patients were treated endoscopically, one laparoscopically and five by open surgery. The endoscopic techniques used were cystogastrostomy in six cases and cystoduodenostomy in one. In the laparoscopic case, we performed loop-sutured cystojejunostomy. The open surgical techniques were cystogastrostomy in four patients and cystoduodenostomy in one. The endoscopic therapy had the shortest procedure time (30 min) in comparison to 110 and 105 min for the laparoscopic and open surgical groups respectively. No mortality was reported in any of the groups. Postoperative complications represent 14%, 40% for the endoscopic and the open surgical groups respectively. The laparoscopic case had no complications. The hospital stay was shorter for both endoscopic and laparoscopic cases than open surgical cases. Because of the limited number of cases, definitive comparative results cannot be concluded. However, it can be stated that minimally invasive therapeutic techniques, whether endoscopic or laparoscopic, for pancreatic pseudocyst could be considered valuable, competitive and promising alternatives for open surgery. Large scale comparative studies are highly recommended in the future.