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The frequency of incidental detection of pancreatic cystic lesions (PCLs) is increasing because of the frequent use of cross-sectionalimaging. The appropriate treatment for PCLs is challenging, and endoscopic ultrasound-guided ablation for PCLs has been reported inseveral studies. Although the feasibility and effcacy of this therapeutic modality have been shown, the safety issues associated with theprocedure are still a concern. We present a case of a 61-year-old man who underwent ultrasound-guided ethanol ablation for PCL andneeded repeated endoscopic balloon dilatation for severe duodenal stricture caused by necrotizing pancreatitis after the cyst ablationtherapy.