PERCUTANEOUS MANAGEMENT OF A BLADDER-DRAINED PANCREAS TRANSPLANT PSEUDOCYST BY A TRANSCYSTIC APPROACH

Background. We describe a 35-year-old male type 1 diabetic who underwe nt a cadaveric combined kidney-bladder-drained pancreas transplant wit h a duodenocystostomy for exocrine drainage who developed a large pelv ic pseudocyst associated with a dilated pancreatic duct and an elevate d serum amylase level. Methods. Due to the risk of surgical revision a nd the possibility of creating a cutaneous fistula with conventional p ercutaneous drainage, a pseudocyst-to-bladder drainage was performed. After the procedure, the catheter was capped to allow drainage of the pancreatic secretions into the bladder. Results. After drainage, the p atient's serum amylase and lipase normalized along with resolution of the pseudocyst. The tube was removed after 19 weeks with no evidence o f a recurrent pseudocyst and a normal serum amylase level. Conclusion. The percutaneous pseudocyst-cystostomy obviated the need for surgical revision of the exocrine gland drainage and thus eliminated the morbi dity and the potential risk of graft loss associated with such surgery .