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Laparoscopic Cystojejunostomy For Pseudocyst Of Pancreas: Which One is Better Suture Or Stapler?

Manash Ranjan Sahoo

Aim: Aim of this study is to compare the results of laparoscopic suture vs stapler cystojejunostomy for pseudocyst of pancreas. Materials and Methods: In this retrospective study of 18 patients including both male and female of age ranging from 15 to 64 years were subjected to laparoscopic cystojejunostomy from April 2007 to july 2013, of which 13 patients underwent suture cystojejunostomy and 5 patients underwent stapler cystojejunostomy. These patients were followed for a period of 18 months assessing first bowel movement, duration of surgery, hospital stay, anastomosis leak, recurrence and morbidity. Result: Duration of surgery was 156.6 ± 10.4 minutes in laparoscopic suture cystojejunostomy and 122 ± 8.8 min in laparoscopic stapler cysto-jejunostomy. Postoperatively, the mean time for the first bowel movement was 36 hrs and 39 hrs, respectively, for suture and stapler cystojejunostomy. Mean hospital stay was six (range: 5-7) days. There was postoperative complication in the form of anastomosis leak that occurred in two patients in stapler cystojejunostomy group. There was no leak in suture group. There were no recurrences. Morbidity was greater in stapler group as leak occurred in two patients. Conclusion: We conclude that laparoscopic suture cystojejunostomy is a safe and feasible procedure and gives superior results in regards to safety of anastomosis and its resultant morbidity. Suture cystojejunostomy is also comparable to stapler in regards to operative time, bowel function and recurrence.