Laparoscopic Versus Open Cystogastrostomy for Pancreatic Pseudocysts: A Comparative Study

Introduction: Pancreatic pseudocyst (PP) is an accumulation of pancreatic juice surrounded by a wall of fibrous or granulation tissue that results from acute, and chronic pancreatitis. To treat PP, various surgical techniques are used including open and laparoscopic cystogastrostomy. Therefore, the current study compared the outcomes of open and laparoscopic cystogastrostomy. Method: The current study included all patients who had open cystogastrostomy (OCG) and laparoscopic cystogastrostomy (LCG) for PPs at Hayatabad Medical Complex Peshawar beginning between 2015 and 2021. The operation time, duration of postoperative hospital stays, and postoperative morbidity and mortality rates were compared between the two surgical techniques. The statistical analysis was carried out using a statistical package for social sciences (SPSS v25). The analysis model for the current study was an intention-to-treat model. Results: There was a significant difference in the patient's BMI across the two groups (median: 25.00 vs 13.00, p = 0.032). The pseudocyst size in patients who underwent LCG was smaller than the OCG (8.50 vs 13.0, p<0.0001). The current study observed that median operation time was significantly less in the LCG compared to OCG (p<0.0001). The postoperative morbidity was higher in OCG compared to the LCG (p=0.001). A smaller hospital stay was observed in patients who underwent LCG compared to OCG (p<0.0001). Conclusion: The current study highlighted that LCG offers significantly better outcomes compared to OCG in terms of operation time, postoperative morbidity and mortality, hospital stay, and postoperative complications.