Post-Operative Complications Among Patients Treated with Cystogastrostomy for Pancreatic Pseudocyst

Abstract

Background: Pancreatic pseudocysts represent a clinical challenge, often resulting from pancreatitis, trauma, or surgery. Traditional management strategies have ranged from conservative treatments to surgical interventions, with varying degrees of invasiveness and associated complications. The evolution of minimally invasive techniques, such as laparoscopic cystogastrostomy (LCG), has offered new avenues for treatment, albeit with an imperative need for a thorough understanding of their outcomes and efficacy. Objective: This study aimed to evaluate the post-operative complications among patients undergoing LCG for pancreatic pseudocysts, contributing to the body of knowledge on patient outcomes and informing clinical practice. Methods: A descriptive case series was conducted at the Department of General Surgery, Lady Reading Hospital, from April 2023 to October 2023. Seventy patients with pancreatic pseudocysts, confirmed via imaging, were included. Those with previous surgeries for pseudocysts were excluded. All procedures were performed by a single experienced consultant. Post-operative complications were monitored within 24-48 hours, including anastomosis leakage, pneumoperitoneum, bleeding, and perforation. Data were analyzed using SPSS version 25, employing mean and standard deviation for continuous variables, and frequencies and percentages for categorical ones. Chi-square tests were used to explore the association between gender and complications, with significance set at p<0.05. Results: Among the patients, 55.7% were female, and 44.3% were male. Post-operative complications included anastomosis leakage (11.4%), pneumoperitoneum (7.1%), bleeding (18.6%), and perforation (4.3%). No significant association was found between gender and any complication (anastomosis leakage p=0.68, pneumoperitoneum p=0.25, bleeding p=0.63, perforation p=0.42). Conclusion: LCG for pancreatic pseudocysts is associated with a notable incidence of complications, including bleeding as the most common. The lack of significant gender disparity in complication rates underscores the procedure's applicability across a diverse patient demographic. These findings advocate for refined surgical techniques and patient management strategies to minimize post-operative risks, contributing to the advancement of care for individuals with pancreatic pseudocysts.