Abstract
Introduction:
To report two unique cases of minimally invasive surgery that were performed in children. The cases illustrate that combined endoscopic and laparoscopic drainage of a pancreatic pseudocyst in children can be accomplished successfully.
Methods:
Two patients, ages 3 and 5 years old, were referred for pancreatic pseudocysts of traumatic origin. A trial of nonoperative treatment and radiologic drainage was unsuccessful. Cystgastrostomy was completed with an endolaparoscopic transgastric stapled anastomosis.
Results:
The average operative time was 100 minutes (range, 90–110 minutes). There was minimal blood loss and no complications. An adequate biopsy specimen was obtained in each patient. A transgastric cyst drainage tube was placed. Diet was resumed the following day. A computed tomography (CT) scan on postoperative day (POD) 5 showed resolution of the pseudocyst. The patients were discharged on POD 5. A 6-month follow-up CT scan showed no recurrence of the pseudocysts, and at follow-up at 12 and 22 months, the children are symptom-free.
Conclusion:
This report of the first pediatric experience with combined endolaparoscopic cystgastrostomy shows that it is safe and effective. With improved pediatric instrumentation and experience, surgical problems can increasingly be managed with more innovative minimally invasive techniques.
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