Endoscopic versus surgical treatment for pancreatic pseudocysts: Feasibility and short-term outcomes

Background: A pancreatic pseudocyst (PP) refers to a confined accumulation of fluid containing high levels of amylase and various enzymes. It is encased by either a fibrous wall or granulation tissue, typically stemming from acute or chronic pancreatitis, pancreatic injury, or obstruction of the pancreatic duct. Treatment options vary in effectiveness and include endoscopic, percutaneous, or surgical interventions. Aim: The objective of this study was to conduct a retrospective analysis to contrast the outcomes of surgical and endoscopic interventions for PP. This analysis will focus on mortality rates, clinical success (defined as complete resolution within a 6-month follow-up period at intervals of 1, 3, and 6 months), recurrence rates, complications, associated costs, and duration of hospital stays. Patients and Methods: Data were retrospectively collected from 50 patients from their medical records and files in the period from July 2018 to July 2021 in Tanta University Hospitals. These patients underwent surgical or endoscopic drainage of PP. Results: No notable distinction was observed in the success rates of treatment, occurrences of adverse events related to drainage or general complications, and recurrence rates between surgical and endoscopic interventions. However, in terms of hospitalization duration, the endoscopic approach yielded superior results. Additionally, concerning treatment costs, the endoscopic method also demonstrated more favorable outcomes. Conclusion: The success rates of surgical and endoscopic treatments for PP showed no significant difference, nor did the occurrence of adverse events or recurrence. However, the endoscopic group exhibited shorter hospitalization durations and lower treatment costs.