Application Of Laparoscopic Techniques In The Treatment Of Pancreatic Pseudocysts

Objective:To evaluate the feasibility,safety and superiority of laparoscopic internal drainage of pancreatic pseudocysts and develop the application of laparoscopy in the treatment of pancreatic pseudocyst by analyzing the clinical effect of laparoscopic internal drainage of pancreatic pseudocysts(LIDP)and open surgical internal drainage of pancreatic pseudocysts(OSIDP).Methods:The clinical data of 46 patients diagnosed as the pancreatic pseudocyst and treated by internal drainage in China-Japan Union Hospital of Jilin University and The Second Hospital of Jilin University from JUN.2011 to AUG.2016 were retrospectively analyzed.22 cases were treated with laparoscopic internal drainage of pancreatic pseudocyst(LIDP)and 24 cases were treated with open surgical internal drainage of pancreatic pseudocysts(OSIDP).To compare and analyze the difference in the clinical indicators which include preoperative general condition(gender,age,size of the cyst),intraoperative condition(operation time,blood loss)and postoperative condition(exhaust time,eating time,postoperative hospitalization time,hospitalization expenses and complications).Results:There was no significant difference between the two groups in preoperative general condition(gender,age,size of the cyst)(P >0.05).The average operation time of LIDP and OSDIP were(121.13±25.53)min and(130.83±14.34)min(P >0.05)respectively.The average blood loss of the two groups were(87.72±24.48)ml and(103.75±26.83)ml(P<0.05)respectively.The average exhaust time of the two groups were(3.00±1.02)and(3.79±1.10)d(P<0.05)respectively.The average eating time of the two groups were(3.09±0.97)d and(3.87±0.99)d(P<0.05)respectively.The average postoperative hospitalization time of the two groups were(4.90±1.54)d and(8.66±3.71)d(P<0.05)respectively.The average hospitalization expenses of the two groups were(43402.06±6424.47)Yuan and(37668.45±11249.01)Yuan(P<0.05)respectively.Two patients suffered complications in 22 patients of LIDP(9.09%).Both of them were biochemical leakage.Other patients had no complication.Four patients suffered complications(Biochemical Leakage in 2 cases,Grade B in 2 cases)in 24 patients of OSIDP(16.67%),two of them were pancreatic fistula complicated with postoperative hemorrhage.Conclusion:Laparoscopic internal drainage of pancreatic pseudocysts has the advantages of less trauma,clear visual field,less intraoperative blood loss,the faster postoperative recovery,shorter hospitalization time and lower complication rate.Laparoscopic internal drainage of pancreatic pseudocysts didn’t increase the operation time,but the cost of hospitalization was higher than open surgical internal drainage of pancreatic pseudocysts.Laparoscopic internal drainage of pancreatic pseudocysts is simple and easy and the surgical equipment requirements are not high.In the strict control of surgical indications and choosing a reasonable surgical approach,laparoscopic internal drainage of pancreatic pseudocysts is safe and feasible.It is worth popularizing widely.