Percutaneous balloon dilation with or without placement of an external biliary drain is a nonoperative alternative method for treating benign bilioenteric anastomotic strictures. Although this procedure has a high technical success rate, outcomes are less optimal when attempting to dilate refractory tight strictures. For the stricture, cutting balloon can be an option. We present four patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation. To the patients, a peripheral cutting balloon over-the-wire system was inflated, following subsequent conventional non-compliant balloon dilation. After the balloon dilation treatment, an external drainage catheter was placed through the stricture site and maintained for up to 30 days. Technical and end-treatment success was achieved in all four patients. In conclusion, the use of cutting balloon dilation may appear to be a safe and effective alternative method of treatment in patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation.

In severe acute pancreatitis, accompanied by local complications such as acute peripancreatic fluid collection, pancreatic pseudocyst, acute necrotic collection and walled-off necrosis, the mortality rate is as high as 12-25%. In many cases, interventional procedure or surgical treatment are required at an appropriate time. Conservative treatment is considered for acute peripancreatic fluid collection. Endoscopic drainage could be considered preferentially for the treatment of pancreatic pseudocysts with clinical symptoms or complications. In the case of necrotizing pancreatitis, conservative treatment is preferred, but therapeutic intervention should be considered if infectious pancreatic necrosis with clinical deterioration is suspected. For therapeutic intervention, it is recommended to proceed with a step-up approach in which drainage is first performed and, if necessary, necrosectomy is performed. The optimal timing of intervention is considered 4 weeks after the onset of pancreatitis when necrosis become walled-off, but early drainage within 4 weeks can be considered depending on the patient's condition. This guideline provides an overview of current treatment strategies for local complications of acute pancreatitis.

췌아세포종은 주로 유년기에 발생하지만, 성인에서도 발생하는 아주 드문 췌장의 종양이다. 성인에서 발생하는 경우예후가 나쁘지만, 조기 진단 및 수술적 절제가 장기 생존율을 향상시킬 수 있다. 영상학적 검사에서는 고형 유두상 상피성 종양, 관샘암종, 세엽세포암 등을 감별진단에 포함시켜 야 한다. 수술적 완전 절제가 원칙이며, 수술후 보조 항암치료 및 항암방사선치료의 경우 아직 연구가 부족한 실정이다. 저자들은 소화불량으로 내원하여 영상학적 검사에서 우연히 발견된 췌장 종괴로 고형 유두상 상피성 종양을 의심 하에 수술을 계획하였고, 수술후 조직학적으로 췌아세포종을 진단하여 보고하고자 한다.