# Minimally Invasive Management of a Giant Pancreatic Pseudocyst Following Acute Pancreatitis: A Case Report and Literature Review

## TL;DR

A 23-year-old man with a large pancreatic fluid collection following pancreatitis was successfully treated with laparoscopic drainage, but later developed an abscess requiring medical treatment.

## Contribution

This case report demonstrates the effectiveness of laparoscopic drainage for complex pancreatic fluid collections and emphasizes the need for postoperative monitoring.

## Key findings

- Laparoscopic extragastric cystogastrostomy successfully drained a 18.5 cm pancreatic fluid collection.
- The patient developed a peripancreatic abscess postoperatively, managed medically.
- The case supports minimally invasive management for large, symptomatic pancreatic collections.

## Abstract

Pancreatic fluid collections (PFCs) are a known complication of pancreatitis. According to the Revised Atlanta Classification, these can mature into either a pancreatic pseudocyst or walled-off necrosis (WON), the latter containing solid debris. While many collections resolve spontaneously, large, symptomatic, or complicated ones require intervention. Laparoscopic drainage is a key minimally invasive option. We present the case of a 23-year-old male patient with presumed alcohol-related pancreatitis who developed a giant 18.5 cm PFC. After six weeks of conservative management, a laparoscopic extragastric cystogastrostomy was performed due to persistent symptoms, draining 600 mL of necrotic material, suggesting the collection was consistent with WON. The patient was readmitted 20 days postoperatively for a peripancreatic abscess, which was managed medically. This case highlights the successful laparoscopic management of a large, complex PFC and underscores the importance of structured postoperative surveillance for infectious complications.