Successful cystic fenestration for a macrocystic serous cystadenoma of the pancreas causing obstructive jaundice: report of a case.
A 72-year-old man was admitted to our hospital for investigation of jaundice. We made a preoperative diagnosis of macrocystic serous cystadenoma (SCA) of the pancreas, but did not perform palliative choledochojejunostomy because aspiration of the pancreatic cystic fluid caused the cysts to shrink and relieved the compressive stenosis of the common bile duct (CBD) during the operation. Frozen sections of the cyst wall taken by incision biopsy showed no signs of malignancy. Therefore, we performed fenestration of the cystic wall after fixing the inner epithelium of the cyst with 100% ethanol and aspirating the cystic fluid. Cholangiography after the cystic fenestration showed resolution of the CBD stenosis and abdominal computed tomography (CT) confirmed the disappearance of the pancreatic cysts. No recurrence of cystic swelling or obstructive jaundice has been detected by abdominal CT or laboratory data for more than 2 years since the cystic fenestration. Thus, cystic fenestration may be a better palliative option for treating benign compressive tumors such as macrocystic SCA of the pancreas causing obstructive jaundice.
Watanabe
Hiroyuki
H
Department of Internal Medicine and Medical Oncology, Cancer Research Institute, Kanazawa University, Graduate School of Medical Science, Takaramachi 13-1, Kanazawa 920-8641, Japan.
Ohtsubo
Koushiro
K
Yamaguchi
Yasushi
Y
Mouri
Hisatsugu
H
Motoo
Yoshiharu
Y
Noto
Masahiro
M
Kitagawa
Hirohisa
H
Kayahara
Masato
M
Ohta
Tetsuo
T
Gabata
Toshifumi
T
Sakamoto
Shigeo
S
Sawabu
Norio
N
D000368:Aged; D018293:Cystadenoma, Serous / Q000150:complications / Q000601:surgery*; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D008297:Male; D010181:Pancreatic Cyst / Q000150:complications / Q000601:surgery*