Laparoscopic PP surgery was completed successfully in 28 of 29 patients.

The
overall mean operative time was 2.8 hours and the mean postoperative length of
stay was 4.4 days. Of the techniques described, the authors prefer cyst gastrostomy
by the lesser sac approach or the minilaparoscopic cystic gastrostomy. LDP was
attempted in 25 patients and completed successfully in 23. One underwent a
successful hand-assisted enucleation of an insulinoma. In 12 cases the spleen was
preserved. Mean operative time was 3.7 hours, and mean postoperative length of
stay was 4.1 days.
CONCLUSIONS:
In the authors' experience, minimally invasive treatment of PP produces good results
and avoids difficulties linked with percutaneous drainage or endoscopic internal
procedures. However, combining upper endoscopy with
intragastric laparoscopic surgery offers advantages of both. LDP compares well to
open procedures and often allows preservation of the spleen.