Figure 1. Endoscopic ultrasound (Olympus UM130 radial scanner) of pancreatic pseudocyst.

Figure 2. Endoscopic view of different steps of pancreatic pseudocyst drainage. The point of entrance (as assessed by endoscopic ultrasonography) is marked with a biopsy forceps (left upper corner). After cutting through the wall with a needle-knife, a guidewire is placed into the pseudocyst (right upper corner), the opening is widened with an 8-mm balloon (left lower corner), and 2 double pigtail stents are placed over guidewires (left lower corner), allowing drainage of the pseudocyst.

Figure 3. Radiologic view of the pseudocyst after injection of contrast and placement of a guidewire.

Figure 4. Algorithm for the management of pancreatic pseudocysts.

ERCP = endoscopic retrograde cholangiopancreatography; EUS = endoscopic ultrasonography; CA = cancer