Safety and feasibility of laparoscopic pericardioperitoneal window

Background Recurrent pericardial effusion remains a diagnostic and therapeutic challenge due to high recurrence rates. Laparoscopic pericardioperitoneal window represents an understudied method in the management of pericardial effusion and is a minimally invasive technique that allows continuous drainage, achieving symptomatic improvement with minimal recurrence. Methods We conducted a single-centre prospective study between 2022 and 2024, including patients with recurrent pericardial effusion requiring surgical intervention. A pericardioperitoneal window was created via laparoscopy for all patients. Clinical outcomes, complications and recurrence rates were assessed over a 12-month follow-up period. Results 24 patients were included, and all patients tolerated the surgical procedure well. The surgery was technically successful in all patients, resulted in direct symptomatic improvement and none experienced postoperative complications. Postoperative drainage was not needed, and patients were discharged the next day. 12-month follow-up revealed no clinical or radiological signs of recurrence. Conclusions Laparoscopic pericardioperitoneal window appears to be a safe, effective and durable alternative for patients with recurrent pericardial effusion. However, larger randomised controlled trials are required for further assessment of safety and long-term outcomes.