Excision of a Giant Huge Idiopathic Pseudo-Pancreatic Cyst: A Case Report

A pseudo-pancreatic cyst is a common clinical entity characterized by a fibrous tissue wall which is devoid of epithelium with localized fluid rich in pancreatic enzymes as amylase [1]. Its incidence reaches 30-40% after pancreatitis [1, 2], decompression is indicated when symptomatic cysts persist for more than six weeks and for those larger than six centimeters [3]. A classification of pancreatic pseudocyst was described by D’Egidio and Schein, in 1991, with three types according to inflammatory process, pancreatic duct anatomy, and cyst communication to the ductal system [4]. Another more complex classification of seven categories based on pancreatic duct anatomy, is suggested by Nealon and Walser 2002 [5]. Long-standing and large-sized cysts are more likely to have complications. Those patients need surgical intervention [6]. Cysto-gastrostomy is the standard drainage procedure via laparotomy [7], however minimal access techniques as radiological guided, endoscopic or laparoscopic drainage can reduce the morbidity of laparotomy [8]. When the surgeon is not certain that the cystic mass is a pseudocyst of the pancreas drainage is considered as contraindication [9].