Endoscopy 2011; 43 - A115
DOI: 10.1055/s-0031-1292186

EUS-guided transjejunal pancreatic pseudocyst drainage in a patient who underwent totalgastrectomy with roux-en Y anastomosis

Tsuji Shujiro 1, Itoi Takao 1, Sofuni Atsushi 1, Itokawa Fumihide 1, Tsuchiya Takayoshi 1, Kurihara Toshio 1, Ishii Kentarou 1, Nobuhito Ikeuchi 1, Umeda Junko 1, Tanaka Reina 1, Moriyasu Fuminori 1
  • 1Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan

Background: EUS-guided pseudocyst drainage is safety and reasonable and an effective treatment. However EUS-guided transjejunal drainage has been described in only few reports.

Objectives: To describe our successful experience with EUS-guided transjejunal pseudocyst drainage in a 58 year-old man who underwent totalgastrectomy for gastric cancer with roux-enY anastomosis.

Design: A single case report.

Patient: The patient was a 58-year-old man with totalgastrectomy and roux-enY anastomosis. He was treated as alcholic pancreatitis 1year ago. After a conservative treatment, he was admitted a pancreatic pseudocyst at the head of pancreas. Follow-up CT examination 4 months later showed an increase in the size of the pseudocyst. The size of the pseudocyst was 13cm which occupied entirely upper abdominal cavity. Therefore it caused his upper abodominal distension.

Intervention: EUS-guided transjejunal pseudcyst drainage was performed in a 58 year-old man who underwent totalgastrectomy for gastric cancer with roux-enY anastomosis.

Main Outcome Measurements: Complications and successful treatment of symptoms were the primary endpoints.

Results: EUS-guided transjejunal pseudocyst drainage was performed successfully simultaneous placement of stent (6Fr double pig tail) and nasocystic catheter (5Fr pigtail) for pancreatic pseudocyst. Finally, the huge pseudocyst and symptom were disappeared, and this patient was discharged. There was no major adverse event.

Conclusions: EUS-guided transjejunal psudocyst drainage is a reasonable, technically feasible and encouraging treatment. However, we should continue to estimate and accumulate more cases.