Minimally invasive approaches for pancreatic pseudocysts: robotic cystgastrostomy

Abstract

Presenter: Ola Ahmed MD | Washington University, St. Louis Background: The majority of pancreatic pseudocysts resolve without the need for operative intervention. In a select few, surgery may be warranted for large cysts causing symptoms and unamenable to endoscopic or percutaneous drainage procedures Methods: We present the case of 2 patients: a 35 year old lady with a background of EtOH-related pancreatitis and a 43 year old gentleman with a history of gallstone pancreatitis. Both patients developed large symptomatic pancreatic pseudocysts that were unsuited to drain insertion because of the size of the cavity and the presence of a large amount of necrotic debris. Their symptoms of abdominal pain, fullness and early satiety persisted over an 8 – 10 week period and the patients underwent a robotic cystgastrostomy with pancreatic debridement. Results: The post-operative course for both was uneventful and one patient was discharged post-op day 1 while the second patient required a longer stay for social issues and was discharged on day 6. Conclusion: Pancreatic pseudocysts seldom require operative intervention. In a select number of patients, robotic cystgastrostomy is safe and feasible and the robotic approach can be advantageous with enhanced angulation and offering 3 dimensional views for complex retroperitoneal structures