Laparoscopic cystogastrostomy for the treatment of pancreatic pseudocysts in children

Pancreatic pseudocysts (PPSs) are common sequelae of pancreatitis and pancreatic trauma. The management is based upon the pseudocyst size and presence of symptoms. Those requiring intervention are often drained using several available options. The use of laparoscopic cystogastrostomy for large and r...

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Bibliographic Details
Published inJournal of pediatric surgery Vol. 40; no. 11; pp. e13 - e17
Main Authors Saad, Daniel F., Gow, Kenneth W., Cabbabe, Samer, Heiss, Kurt F., Wulkan, Mark L.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.11.2005
Subjects
Child
Drainage
Female
Gastrostomy - methods
Humans
Laparoscopy
Pancreatic Pseudocyst - surgery
Recurrence
Treatment Outcome
Laparoscopic cystogastrostomy
Pancreatic pseudocyst
Laparoscopy
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Summary:Pancreatic pseudocysts (PPSs) are common sequelae of pancreatitis and pancreatic trauma. The management is based upon the pseudocyst size and presence of symptoms. Those requiring intervention are often drained using several available options. The use of laparoscopic cystogastrostomy for large and recurrent PPSs has been described in adult patients as a less morbid alternative to open drainage procedures. This technique is considered a novel approach in children. We describe 2 children who had PPSs amenable to laparoscopic cystogastrostomy. The first was an 11-year-old girl who had blunt abdominal trauma from a bicycle handlebar. The second patient was a 7-year-old girl who developed idiopathic pancreatitis. Briefly, 2 ports were placed through the anterior abdominal and gastric walls, and into the lumen of the stomach. This intraluminal placement provided access to the posterior gastric wall. Using electrocautery diathermy, an incision was made through the posterior gastric wall and into the adjacent pseudocyst to obtain complete and unobstructed drainage. Both children tolerated the procedures well with resolution of their PPSs. The patients were each discharged on the fourth postoperative day and have been asymptomatic on 2 years follow-up. Laparoscopic cystogastrostomy is a safe and effective alternative to open cystogastrostomy for the minimally invasive management of PPSs in the pediatric population.
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ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2005.07.041