REPEATED PERCUTANEOUS ASPIRATION THERAPY PRIOR TO SURGERY FOR A PANCREATIC PSEUDOCYST - REPORT OF A CASE

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