Operative views of the cyst illustrating management steps. (a) Extended Kocher maneuver revealed a big cyst compressing the third part of the duodenum, with close relation to the head of the pancreas. (b) The duodenum was opened through the lateral wall of the second part, which showed the internal common wall between the cyst and the third part of the duodenum. The lumen of the of the third part of the duodenum was completely occluded. The common wall was opened using a GIA-stapler (not shown). (c) The cyst collapsed after marsupialization and duodenojejunal anastomosis was performed (c: cyst, j: jejunum, numbers: corresponding parts of the duodenum).