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

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.