1992 Volume 34 Issue 3 Pages 620-626_1
Endoscopic sphincterotomy of the pancreatic orifice (EPST) is useful for preserving the function of the pancreas and decreasing pain in the cases of chronic pancreatitis accompanying pancreatolithiasis. On the other hand, for cases with pancreatic pseudocyst, surgery has been the only therapy of choice. We successfully treated endoscopically one case of 27-year-old male with chronic alcoholic pancreatitis associated with pseudocyst and lithiasis. The patient was operated on previously, because of an intra-abdominal abscess caused by rupture of a cyst. There were two procedures ; firstly, stone extraction following pancreatic sphincterotomy and secondly, cystoduodenostomy aiming at decompression of the pseudocyst located in the head of the pancreas. The pseudocyst infected with Klebsiella, Serratia and Pseudomonas bacilli caused compression to the duodenum and finally required cystoduodenostomy. A needle papillotome was applied to make a small fistel, when pus overflowed immediately. A standard papillotome was then introduced and completed cystoduodenostomy without complication. According to Sahel, mortality depends upon endoscopic skill, but was 2.1%. Endoscopic cystoduodenostomy or cystgastrostomy offers non-surgical treatment for pseudocyst of the pancreas.
