The challenge for surgical management of a pancreatic pseudocyst during esophagectomy is not only to preserve the gastric wall, but also to avoid forming a pancreatic fistula. We report a case of a 54-year-old man with an esophageal squamous cell carcinoma who had a synchronous pancreatic pseudocyst. Roux-en-Y cystojejunostomy was performed during a McKeown esophagectomy to enable drainage of the pancreatic pseudocyst through the jejunum. The patient recovered after the operation, and the formation of a pancreatic fistula was avoided successfully.
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