Background: Pancreatic pseudocysts, complications of pancreatitis, often necessitate intervention when symptomatic or large. While endoscopic and open surgical cystogastrostomy are established treatments, mini-incision cystogastrostomy (MIC) is a hybrid technique that combines surgical precision with minimal invasiveness, potentially benefiting resource-limited settings. Methods: A retrospective study of five patients with giant pancreatic pseudocysts (14-19 cm diameter) treated with MIC between September 2020 and June 2024 was conducted. Preoperative imaging, including abdominal ultrasound and CT scans, guided surgical planning. A small epigastric incision allowed direct visualization for secure cystogastrostomy. Data on demographics, surgical details, and postoperative outcomes were analyzed, and findings were compared with literature on alternative techniques. Results: The cohort comprised four males and one female (age range: 18-50 years). The mean operative time was 45 minutes (range: 35-60 minutes), and no intraoperative complications occurred. Patients experienced complete symptom resolution, with a mean hospital stay of 4.6 days (range: 4-6 days). Follow-up over 24 months revealed no recurrences or complications. MIC provided secure anastomosis under direct visualization, combining the advantages of minimal invasiveness with surgical efficacy. Conclusion: MIC is a feasible and effective option for giant pancreatic pseudocysts, particularly where advanced endoscopic tools are unavailable. This technique balances the precision of surgery with reduced invasiveness, supporting enhanced recovery and symptom resolution.
