A 62-year-old man was referred to our tertiary hospital for endoscopic therapy of previously diagnosed alcoholic chronic pancreatitis. In the previous year he had been admitted to the referring hospital every 2 months for flares of pancreatitis, which were all treated conserva- tively. He was using nonopioid analgesics. He had no history of a cholecystectomy. Routine laboratory tests did not show any abnormalities. Cross-sectional imaging studies demonstrated 2 obstructive pancreatic duct stones in the pancreatic head with upstream main pancreatic duct dilatation of 7.6 mm. In addition, a 3.3- ? 1.7-cm cyst was located at the pancreatic head in apparent communication with the pancreatic duct (Fig. 1).
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