Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases

Figure 9 Large pancreatic pseudocyst communicating with the main pancreatic duct: combined endoscopic trans-papillary and trans-gastric drainage. A: Contrast injection into the MPD shows a stricture of the main pancreatic duct at the level of the cyst; B: After pancreatic sphincterotomy, the stricture is dilated, a guidewire is inserted into the cyst cavity, and a plastic stent is placed; C and D: Under EUS guidance, a double pig-tail plastic stent is also placed by a single step procedure; D: X-ray imaging shows trans-papillary and trans-gastric stents at the end of the procedure.