Article thumbnail

Pseudocyst in the Pancreatic Tail Associated with Chronic Pancreatitis Successfully Treated by Transpapillary Cyst Drainage

By Itaru Naitoh, Hirotaka Ohara, Yasutaka Okayama, Takahiro Nakazawa, Tomoaki Ando, Kazuki Hayashi, Fumihiro Okumura, Yasuhiro Kitajima, Tessin Ban, Katsuyuki Miyabe, Koichiro Ueno, Takashi Joh and Hitoshi Sano


We report a 50-year-old male with pseudocysts in the pancreatic tail associated with chronic pancreatitis successfully treated by transpapillary cyst drainage. He had previously undergone ultrasonography-guided percutaneous cyst drainage for a pancreatic pseudocyst in our hospital. He was readmitted due to abdominal pain and fever. Computed tomography showed recurrence of a pseudocyst in the pancreatic tail measuring 5 cm in diameter. Since conservative treatment failed, endoscopic retrograde pancreatography was performed. There was communication between the pseudocyst and the main pancreatic duct, and pancreatic duct stenosis proximal to the pseudocyst. First, transpapillary pancreatic duct drainage was performed using a plastic stent, but the pseudocyst did not decrease in size and became infected. After removal of the stent, a pigtail type nasocystic catheter was placed in the pseudocyst via the pancreatic duct. The pseudocyst infection immediately disappeared, and the pseudocyst gradually decreased and disappeared. After removal of the nasocystic catheter, no recurrence was observed. As transpapillary drainage of pancreatic pseudocyst, cyst drainage and pancreatic duct drainage have been reported. In our patient with pseudocyst in the pancreatic tail, duct drainage was ineffective and the pseudocyst was infected, whereas cyst drainage was very effective. We considered that cyst drainage by a nasocystic catheter was the first-line therapy as the transpapillary drainage of the pancreatic pseudocyst

Topics: Published: November 2008
Publisher: S. Karger AG
OAI identifier:
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (2008). AR: Cystic lesions of the pancreas. A diagnostic and management dilemma. Pancreatology
  2. (1989). Engelholm L: Endoscopic management of cysts and pseudocysts in chronic pancreatitis: long-term follow-up after 7 years of experience.
  3. Features and choice of treatment of acute and chronic pancreatic pseudocysts – with special reference to invasive intervention.
  4. (1990). GC: Endoscopic drainage of pancreatic pseudocysts.
  5. H: Endoscopic cystoduodenostomy of cysts of chronic calcifying pancreatitis: a report of 20 cases.
  6. (1995). Hogan WJ: Treatment of pancreatic pseudocysts with ductal communication by transpapillary pancreatic duct endoprosthesis. Gastrointest Endosc
  7. (1989). Hyder SA: Changing concepts in the management of pancreatic pseudocysts. Gastrointest Endosc
  8. (1995). JP: Endoscopic transpapillary drainage of pancreatic pseudocysts. Gastrointest Endosc
  9. LC: Surgical decision-making in the treatment of pancreatic pseudocysts. Internal versus external drainage.
  10. (2007). Maitra A: Precursor lesions of pancreatic cancer: molecular pathology and clinical implications. Pancreatology
  11. (1980). Pancreatic pseudocyst: management by ultrasonographically guided aspiration. Gastrointest Radiol
  12. (1991). Percutaneous catheter drainage of pancreatic pseudocysts. Am Surg
  13. (1975). RW: Transgastric needle aspiration of pancreatic pseudocyst through an endoscope. Gastrointest Endosc
  14. (1995). Soehendra N: Transpapillary and transmural drainage of pancreatic peudocyst. Gastrointest Endosc
  15. (2006). T: A case of chronic pancreatitis associated with infected psedocyst after endoscopic pancreatic stenting. Suizo