✦ PANCREATIC PSEUDOCYSTS · LAPAROSCOPIC

Laparoscopic Cystogastrostomy

Q: Will the pseudocyst recur after laparoscopic cystogastrostomy?

Recurrence occurs in under 5% of cases. MRCP post-operatively assesses whether the pseudocyst communicates with the main pancreatic duct.

Q: Is laparoscopic cystogastrostomy better than open surgery for pseudocysts?

Laparoscopic cystogastrostomy achieves equivalent drainage outcomes through 4 small incisions with less pain and shorter hospital stay.

Q: How is laparoscopic cystogastrostomy different from endoscopic drainage?

Endoscopic uses an EUS-guided stent through the stomach wall. Laparoscopic creates a wide direct surgical window allowing debridement of thick content not drainable endoscopically.

Keyhole surgical internal drainage of a pancreatic pseudocyst into the stomach — for cases not amenable to endoscopic drainage.

90–150 Min TREATMENT DURATION

3–5 Days CARE SETTING

Laparoscopic APPROACH

2–3 Weeks RECOVERY TIMELINE

What is Laparoscopic Cystogastrostomy?

Laparoscopic cystogastrostomy creates a wide surgical drainage window between the posterior gastric wall and the pancreatic pseudocyst through 4 small keyhole incisions. It is performed for pseudocysts not suitable for endoscopic drainage due to anatomy, thick content, or failed endoscopic attempt. Dr. Tagore Mohan Grandhi performs laparoscopic cystogastrostomy. A wide 3–5 cm opening between the pseudocyst and stomach provides permanent internal drainage with a 95%+ success rate and 2–3 day hospital stay.

Suitable for large symptomatic pancreatic pseudocysts not accessible endoscopically, those with thick semi-solid content requiring direct debridement, or those that have failed endoscopic drainage attempts.

How the Procedure Works

Laparoscopic Access

Four keyhole incisions. Transgastric or extragastric approach used to identify the pseudocyst posteriorly.

Cyst Entry

Pseudocyst identified and entered. Fluid aspirated and sent for analysis. Necrotic debris removed under laparoscopic vision.

Drainage Window

Wide 3–5 cm opening created between the posterior gastric wall and the pseudocyst using laparoscopic scissors and electrocautery.

Haemostasis

Anastomotic edges oversewn for haemostasis. Drain placed adjacent to anastomosis.

Recovery

CT at 6 weeks confirms pseudocyst resolution. Return to normal activities in 2–3 weeks.

Outcomes

90–150 MinTREATMENT DURATION

3–5 DaysCARE SETTING

LaparoscopicAPPROACH

2–3 WeeksRECOVERY TIMELINE

Who Needs This Treatment?

→Wide drainage window — superior drainage of thick semi-solid pseudocyst contents
→Keyhole approach — 4 small incisions, 2–3 day hospital stay
→95%+ success rate for definitive pseudocyst drainage
→Direct debridement of necrotic material possible under laparoscopic vision

Laparoscopic cystogastrostomy gives us full surgical control for complex pseudocysts — creating a wide, permanent drainage window through 4 small incisions. For cases where endoscopy is not possible, it is the ideal solution.

— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

Will the pseudocyst recur after laparoscopic cystogastrostomy?+

Is laparoscopic cystogastrostomy better than open surgery for pseudocysts?+

How is laparoscopic cystogastrostomy different from endoscopic drainage?+

Not sure which treatment is right for you?

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