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Dr. Raman Garg Successfully Performs Advanced Minimally Invasive Surgery for a Giant Pancreatic Pseudocyst
Pancreatic pseudocysts are one of the most common complications of pancreatitis. While small pseudocysts may resolve spontaneously, large or symptomatic pseudocysts can cause persistent pain, vomiting, early satiety, gastric compression, infection, bleeding, or rupture, requiring definitive intervention.
Dr. Raman Garg, Senior Surgical Gastroenterologist, Hepatobiliary & Pancreatic (HPB) Surgeon, Advanced Laparoscopic Surgeon, and GI Cancer Surgeon, successfully treated a giant pancreatic pseudocyst measuring 15 × 12 cm using a totally laparoscopic cystogastrostomy, providing durable internal drainage through a minimally invasive approach.
Patient Presentation
A 35-year-old male with a history of chronic alcohol consumption presented with:
- Persistent upper abdominal pain.
- Early satiety.
- Recurrent vomiting.
- Abdominal fullness.
- Progressive difficulty in eating.
A contrast-enhanced CT scan demonstrated a giant pancreatic pseudocyst measuring approximately 15 × 12 cm, occupying a large portion of the upper abdomen and causing significant compression of the stomach.
Advanced Pancreatic Surgery by Dr. Raman Garg
After detailed evaluation, Dr. Raman Garg performed a Totally Laparoscopic Cystogastrostomy at Bombay Gastro & Cancer Institute, Bathinda.
Using advanced keyhole surgical techniques, a wide communication was created between the posterior wall of the stomach and the pancreatic pseudocyst, allowing continuous internal drainage of the cyst contents directly into the stomach.
This minimally invasive procedure eliminates the need for external drainage tubes and provides a durable solution while preserving normal gastrointestinal anatomy.
Excellent Postoperative Recovery
The patient recovered rapidly after surgery:
- Early initiation of oral liquids.
- Smooth progression to a normal diet.
- Significant relief of abdominal pain and fullness.
- Minimal postoperative pain.
- No procedure-related complications.
- Discharged in satisfactory condition on the 3rd postoperative day.
Why This Case Is Important
A giant pancreatic pseudocyst (>10 cm) is a potentially serious complication of pancreatitis and often requires definitive treatment when symptoms persist or the cyst continues to enlarge.
This case demonstrates:
- Successful minimally invasive management of a 15 × 12 cm giant pancreatic pseudocyst.
- Advanced laparoscopic cystogastrostomy with permanent internal drainage.
- Avoidance of major open surgery and external drainage.
- Faster recovery with minimal postoperative pain.
- Excellent functional outcome with early discharge.
This case highlights how modern laparoscopic pancreatic surgery can safely manage even very large pancreatic pseudocysts while minimizing surgical trauma and promoting rapid recovery.
Advanced Pancreatic and HPB Surgery by Dr. Raman Garg
Dr. Raman Garg is a leading Surgical Gastroenterologist, Hepatobiliary & Pancreatic (HPB) Surgeon, Advanced Laparoscopic Surgeon, GI Cancer Surgeon, and Colorectal Surgeon based in Bathinda, Punjab. He has extensive expertise in advanced pancreatic surgery, including laparoscopic cystogastrostomy, surgery for chronic pancreatitis, pancreatic resections, and hepatobiliary procedures, following Enhanced Recovery After Surgery (ERAS) protocols.
Patients from Bathinda, Punjab, Haryana, Rajasthan, and neighbouring states seek treatment from Dr. Raman Garg for advanced pancreatic and gastrointestinal surgical care.
Patient: 35-year-old Male
Diagnosis: Giant Pancreatic Pseudocyst (15 × 12 cm); Chronic Alcohol-Related Pancreatitis
Procedure Performed: Totally Laparoscopic Cystogastrostomy (Internal Drainage of Pancreatic Pseudocyst)
Operating Surgeon: Dr. Raman Garg, Surgical Gastroenterologist, Hepatobiliary & Pancreatic (HPB) Surgeon, Bombay Gastro & Cancer Institute, Bathinda
Outcome: Uneventful recovery with successful internal drainage; discharged on the 3rd postoperative day.
About Dr. Raman Garg
Dr. Raman Garg is a Consultant Surgical Gastroenterologist, Advanced GI, Laparoscopic and HPB Surgeon at Bombay Gastro & Cancer Institute, Bathinda. He specializes in gastrointestinal cancer surgery, liver, pancreas and bile duct surgery, colorectal surgery, hernia surgery, upper GI surgery, emergency abdominal surgery, and advanced minimally invasive procedures.
Patient identity has been withheld to maintain confidentiality. This case is published solely for educational purposes and with due respect for patient privacy.
