# Anatomical landmark-guided laparoscopy for migrant fishbone - induced pancreatic abscesses: a case series study and review of the literature

## TL;DR

This paper presents a new laparoscopic method using anatomical landmarks to treat rare pancreatic abscesses caused by fishbone migration, showing faster recovery and fewer complications.

## Contribution

A novel laparoscopic surgical approach using anatomical landmarks for treating fishbone-induced pancreatic abscesses is introduced and validated.

## Key findings

- The laparoscopic method achieved minimal operative time and blood loss without complications.
- Postoperative hospitalization was significantly reduced compared to conventional methods.
- The technique matched ARN-assisted methods in hemostatic efficacy without requiring preoperative conditioning.

## Abstract

Pancreatic abscesses resulting from gastrointestinal fishbone migration represent rare yet clinically challenging surgical emergencies, with standardized management protocols remaining undefined.

We analyzed three consecutive cases (2024–2025) treated via anatomical landmark-guided laparoscopy alongside 11 PubMed-indexed cases (2004–2025). This study evaluates a novel surgical paradigm for complete foreign body retrieval and abscess resolution.

The laparoscopic strategy achieved technical precision with minimal operative duration (73 ± 6 min) and blood loss (6.67 ± 4.71 mL), eliminating pancreatic fistula or hemorrhagic complications. Postoperative hospitalization was reduced by 43% compared to conventional interventions (5.3 ± 1.5 vs. 9.3 ± 3.1 days; *p* < 0.01). Crucially, this strategy attained hemostatic efficacy equivalent to augmented reality navigation (ARN)-assisted techniques without preoperative conditioning.

These findings establish a reproducible framework integrating anatomical landmark navigation for emergency pancreatic abscess management. The approach offers clinically validated advantages in procedural safety, visceral preservation, and accelerated recovery trajectories compared to existing strategies.