This technique has been used routinely in those patients in whom the cyst is adherent to the wall of the stomach as well as in two instances in which the cyst is located in the head of the pancreas in apposition with the duodenum; thus, a cystoduodenostomy was performed. This technique bypasses the initial gastrostomy incision, reduces blood loss and avoids making a blind incision through the posterior wall of the stomach or the duodenum with cystoduodenostomy.