A CASE OF CHRONIC PANCREATITIS ASSOCIATED WITH MULTIPLE RETENTION CYSTS AND PANCREATOLITHIASIS

Multiple pancreatic cysts and calcification were found in a 58-year-old male with chronic alcohl abuse by imaging modalities, who was diagnosed as chronic pancreatitis and underwent laparotomy on January 9, 1989. Preservation of pancreatic function was intended. Five cysts were identified, two of which were removed by caudal pancreatectomy. The main pancreatic duct was incised longitudinally, followed by the removal of pancreatolith in the duct. Pancreatojejunostomy with Roux-Y limb was performed. Two cysts located between the head and body were included in the anastomosis. The remaining cyst in the head was treated by injection of 95% ethanol to sclerose the lining epithelia. Histologically, retention cysts arising from the pancreatic duct and chronic pancreatitis were identified. The patient was reoperated on bacause of a bleeding gastric ulcer. Although the ethanol-injected cyst at the head had shrunken at the gastrectomy, another cyst was noted at the uncus, which was also treated by inlection of ethanol. The patient later underwent lysis of small bowel obstruction, when these ethanol-injected cysts had disappeared. He had no suggestive complaint of recurrent pancreatitis since the surgery, and these cysts had not recurred on CT 10 months following his initial surgery.