An economical and feasible method with little trauma for a giant pancreatic pseudocyst communicating with main pancreatic duct: a case report and literature review.

Pancreatic fluid collection is a common complication of both acute and chronic pancreatitis, often presenting as pancreatic pseudocysts (PPCs) or walled-off pancreatic necrosis. Treatment options for PPCs include percutaneous catheter drainage (PCD), surgical drainage (SD), and endoscopic drainage (ED). However, due to the lack of large studies and prospective randomized data, the optimal approach for managing large PPCs remains controversial. Here, we report a case of a patient with a documented history of acute pancreatitis who developed a PPC measuring approximately 5.9 cm × 4.9 cm × 7.7 cm, located posterior to the pancreatic head. He underwent a combined endoscopic and nutritional strategy that involved pancreatic duct stenting for internal drainage, along with the placement of a nasojejunal tube for enteral feeding. After 2 months, the patient showed clinical improvement and a reduction in the size of his PPC on imaging studies. This case highlights that the implantation of a pancreatic duct stent, combined with a nasojejunal nutrition tube, may offer a cost-effective and minimally invasive approach for managing large PPCs that communicate with the main pancreatic duct.