Stapled laparoscopic cystgastrostomy: a series with 15 cases.
BACKGROUND
The goal of this study was to assess the clinical outcome of patients undergoing laparoscopic stapled cystgastrostomy for pancreatic pseudocysts in contact with the posterior wall of the stomach.


METHODS
We performed a case note review of all patients who have undergone stapled laparoscopic cystgastrostomy in Norwich, UK. The cystgastrostomy was fashioned through an anterior gastrotomy using a vascular ETS stapling device in all cases.


RESULTS
Fifteen patients have undergone stapled laparoscopic cystgastrostomy. The procedure was completed successfully in 12 patients. Three procedures were converted to open surgery for technical reasons. There were no complications due to bleeding from the cystgastrostomy. Early complications included systemic sepsis (one), bleeding gastric ulcer (one) and pseudocyst recurrence due to partial closure of the cystgastrostomy (two). No late recurrences or other complications have been found at a median follow-up of 37 months.


CONCLUSIONS
Stapled laparoscopic cystgastrostomy is a safe and effective procedure for draining pancreatic pseudocysts in contact with the posterior wall of the stomach. The use of a hemostatic stapling device to fashion the cystgastrostomy may reduce the risk of catastrophic hemorrhage from the pseudocyst wall.
Hindmarsh
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A
Department of General Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK. andrewhindmarsh@hotmail.com
Lewis
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MP
Rhodes
M
M
D000328:Adult; D000368:Aged; D005260:Female; D005774:Gastrostomy / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000601:surgery*; D013272:Stomach Diseases / Q000209:etiology / Q000601:surgery*; D013537:Sutures