囊胞胃吻合術により軽快した仮性膵囊胞の1例

抄録

A 43-year-old man was admitted with a painfull pancreatic cyst. He had a long history of alcohol abuse and had presented with acute alcoholic pancreatitis four years previously. After that episode, alcohol consunption was repeatedly associated with pain in the right iliac fossa.
Ultrasound and CT scanning of the abdomen revealed a cystic structure in the anterior aspect of the pancreatic body. ERCP showed dilatation and tortuosity of the main pancreatic duct. Based on the ERCP findings the clinical diagnosis was chronic pancreatitis complicated by pseudocyst. The objective findings, inflammatory reaction, etc, resolved in response to medical treatment.
However, the cyst was sometimes symptomatic and giant in size (8×4.5cm) . It showed no tendency to shrink and a drainage procedure was required. Although we initially attempted laparoscopic cyst-gastrostomy, the wall of cyst was free in the abdominal space and had no point of attachment to the digestive duct. We therefore performed surgical cyst-gastrostomy, which resulted remarkable reduction in the size of cyst. There are several approaches to the treatment of symptomatic pancreatic pseudocyst, in addition to the surgery, such as laparoscopy, etc.