COMBINED PERCUTANEOUS-ENDOSCOPIC PANCREATIC PSEUDOCYST DRAINAGE - A NEW TECHNIQUE

Surgical drainage has been the traditional approach to treating pancre atic pseudocysts, Percutaneous and endoscopic treatment of pancreatic pseudocyst were recently suggested as an alternative to surgery. In or der to avoid the difficulties that can be observed in some patients in the percutaneous or endoscopic management of pancreatic pseudocysts w e have used a combined procedure. We have treated by the ''rendezvous' ' technique two patients suffering from pancreatic fistula complicatin g pancreatic pseudocysts. A percutaneous-endoscopic approach was used to place an internal stent between the pseudocyst and the duodenum, We have applied the same combined approach to the main pancreatic duct t hat is usual for bile duct obstruction without noticeable complication s. Although application of this technique will be very limited, we adv ocate in the future the combined approach to treating pancreatic pseud ocyst when there is a fistula between the fluid collection and pancrea tic duct, and the downstream main pancreatic duct is obstructed, preve nting use of the transpapillary approach.