Surgical Outcomes of Laparoscopic Cystogastrostomy For Pancreatic Pseudocysts: A Retrospective Study.

Introduction Pancreatic pseudocysts (PP) following pancreatitis pose a management challenge. Radiological and endoscopic methods may result in partial resolution or relapse and are chosen based on pseudocyst size, location, and anatomy. Minimally invasive approaches, particularly laparoscopic cystogastrostomy, are increasingly effective. The laparoscopic transgastric luminal cystogastrostomy technique facilitates complete necrosis debridement and internal drainage with minimal invasiveness. Materials and methods We retrospectively reviewed 25 symptomatic, radiologically confirmed patients who underwent laparoscopic cystogastrostomy between 2015 and 2024. Data collected included demographics, cyst characteristics, pancreatitis etiology, BMI, ASA grade, timing, operative details, complications, hospital stay, and return to normal activity. Short- and long-term outcomes were evaluated. Results The mean patient age was 55 years (range: 29-80), with 60% male. Gallstones caused PP in 60% of cases. Pseudocysts were located in the pancreatic body (60%) or head/neck (40%). Endoscopy failed in 60% and percutaneous drainage in 40% before surgery. The average BMI was 31 kg/m²; 56% were ASA grade 3. No conversions or perioperative mortalities occurred. The median interval from presentation to surgery was 79 days, with a mean operative time of 135 minutes and blood loss of 150 cc. ICU admission was required in 40% for a mean of 1 ± 0.5 days. The mean hospital stay was 5 ± 1 days. One patient had a procedure-related complication. At one month, 84% showed complete pseudocyst resolution; the rest resolved within four additional weeks. No recurrences, reoperations, or late complications were observed during a mean nine-month follow-up. Conclusion Laparoscopic cystogastrostomy offers a safe, effective, and cosmetically favorable option for PP management, with high resolution and no recurrences in our series.