Repeated Percutaneous Aspiration Therapy Prior to Surgery for a Pancreatic Pseudocyst: Report of a Case

Abstract

We describe herein the case of a patient with a giant pancreatic pseudocyst which was first treated with repeated percutaneous aspiration therapy, then cured surgically by a Roux-en Y cystojejunostomy, 26 weeks after its formation. A 41-year-old man developed alcohol-induced acute severe pancreatitis. Computed tomography (CT) performed 10 weeks after the onset revealed a giant cyst, 20 x 18 x 7cm in size, arising from the body and tail of the pancreas and extending to the left loin. Endoscopic retrograde pancreatography (ERP) showed a normal main pancreatic duct without communication to the pseudocyst. As the asymptomatic pseudocyst, the wall of which was less than 2mm thick, had not resolved by 8 weeks after its formation, percutaneous aspiration therapy was performed three times. The patient was treated as an outpatient without any complications. The cyst wall was subsequently confirmed to be mature enough for surgical management to be initiated, and a cystojejunostomy was safely performed. Thus, percutaneous aspiration therapy can enable the surgeon to observe maturation of the cyst wall for a long period in patients with a pancreatic pseudocyst.

Inpatient Management and Treatment of a Giant Pancreatic Pseudocyst: A Case Report

“…The term "giant" pancreatic pseudocyst is defined in literature as pseudocyst measuring >10 cm in diameter [4]. Giant pancreatic pseudocysts are a rare occurrence, as investigations into literature show that there have only been a small handful of cases of "giant" pancreatic pseudocyst reported [5][6][7][8][9][10][11]. This is a case presentation of a giant pancreatic pseudocyst secondary to chronic alcoholism, including the treatment by way of endoscopic ultrasound-guided cystogastrostomy.…”

Giant pseudocyst of the pancreas: A report of three cases

“…Pancreatic pseudocysts are rather common complication of pancreatitis. However, few cases of giant pancreatic pseudocysts, which measure 10 cm or more in widest diameter, have been reported in the literature [ [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] ]. The synonyms of huge or large are used in the scientific reports of giant pseudocysts [ [12] , [13] , [14] ].…”