Successful cystic fenestration for a macrocystic serous cystadenoma of the pancreas causing obstructive jaundice: report of a case

• Published in: Surgery today (Tokyo, Japan) Japan), 2006-01, Vol.36 (1), p.89-93
• Main Authors: Watanabe, Hiroyuki, Ohtsubo, Koushiro, Yamaguchi, Yasushi, Mouri, Hisatsugu, Motoo, Yoshiharu, Noto, Masahiro, Kitagawa, Hirohisa, Kayahara, Masato, Ohta, Tetsuo, Gabata, Toshifumi, Sakamoto, Shigeo, Sawabu, Norio
• Format: Article
• Language: English
• Subjects: Aged; Cystadenoma, Serous - complications; Cystadenoma, Serous - surgery; Humans; Jaundice, Obstructive - etiology; Male; Pancreatic Cyst - complications; Pancreatic Cyst - surgery
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-005-3079-3

A 72-year-old man was admitted to our hospital for investigation of jaundice. We made a preoperative diagnosis of macrocystic serous cystadenoma (SCA) of the pancreas, but did not perform palliative choledochojejunostomy because aspiration of the pancreatic cystic fluid caused the cysts to shrink and relieved the compressive stenosis of the common bile duct (CBD) during the operation. Frozen sections of the cyst wall taken by incision biopsy showed no signs of malignancy. Therefore, we performed fenestration of the cystic wall after fixing the inner epithelium of the cyst with 100% ethanol and aspirating the cystic fluid. Cholangiography after the cystic fenestration showed resolution of the CBD stenosis and abdominal computed tomography (CT) confirmed the disappearance of the pancreatic cysts. No recurrence of cystic swelling or obstructive jaundice has been detected by abdominal CT or laboratory data for more than 2 years since the cystic fenestration. Thus, cystic fenestration may be a better palliative option for treating benign compressive tumors such as macrocystic SCA of the pancreas causing obstructive jaundice.