Endoscopic ultrasonography-guided cystogastrostomy for large pancreatic pseudocyst with obstructive jaundice--a case report.
The patient was a 45-year-old man with a history of heavy drinking. A pseudocyst about 30 mm in diameter was found in the head of his pancreas. About four weeks later an upper abdominal mass, abdominal pain and obstructive jaundice were confirmed. Abdominal CT revealed that the cyst had increased in size to about 60 mm, compressing the lower common bile duct and the surrounding digestive tract. Therefore endoscopic ultrasonography-guided cystogastrostomy following percutaneous transhepatic biliary drainage (PTBD) was performed. Postoperatively, the cyst quickly decreased in size and jaundice improved. Because of persistent common bile duct stenosis, an endoscopic retrograde biliary stent was implanted. There has been no recurrence at ten months after the endoscopic therapy. While invasive surgery is generally employed in the treatment of pancreatic pseudocyst complicated by obstructive jaundice, EUS-guided cystogastrostomy appears to be a useful procedure, particularly when considering the relatively minor degree of surgical invasion.
Okabe
Yoshinobu
Y
Department of Medicine, Kurume University School of Medicine, Kurume, Japan. YIB01074@nifty.com
Tsuruta
Osamu
O
Wada
Yuki
Y
Wada
Kazuhiko
K
Suga
Hideya
H
Kudoh
Maisa
M
Kawahara
Ryuichi
R
Kodama
Takatoshi
T
Kinoshita
Hisafumi
H
Toyonaga
Atsushi
A
Sata
Michio
M
D004322:Drainage; D019160:Endosonography; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*