Single-step versus 2-step management of huge pancreatic pseudocysts: a prospective randomized trial with long-term follow-up.

Abstract

OBJECTIVES:

Single-step endoscopic ultrasonography-guided puncture through the stomach to insert a double-pigtail stent to drain a pseudocyst usually resulted in a high infection rate. The 2-step method, which combines the single-step method with a nasocystic drain, was created to help alleviate infections. Our study compared the 2 management strategies.

METHODS:

Between January 2007 and December 2011, patients with huge pancreatic pseudocysts were randomized into either a single-step or a 2-step treatment. Complications from infections and long-term results assessed during follow-up for the 2 groups were compared.

RESULTS:

Forty-seven patients were enrolled-23 in the single-step group and 24 in the 2-step group. There were significant differences in the infection rates (56.52 vs 20.83, P < 0.05), the average days of hospitalization (22.96 ± 2.82 days vs 10.38 ± 1.35 days, P < 0.05), postoperative hospital stay (15.31 ± 3.82 days vs 7.21 ± 1.61 days, P < 0.05), and the disappearance time of the pseudocyst (14.10 ± 2.33 weeks vs 11.70 ± 2.21 weeks, P < 0.05) between the 2 groups; however, there was no significant difference in the pseudocyst recurrence rate.

CONCLUSIONS:

The preferred treatment of a huge pancreatic pseudocyst is a combined endoscopic ultrasonography method using 2 double-pigtail stents and a nasocystic drain.

• Authors: Haicheng Yuan, Mingfang Qin, Rong Liu, Sanyuan Hu
• Journal: Pancreas (Pancreas) Vol. 44 Issue 4 Pg. 570-3 (May 2015) ISSN: 1536-4828 [Electronic] United States
• PMID: 25875795 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Topics

• Adolescent
• Adult
• Aged
• Drainage (instrumentation, methods)
• Endosonography
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Pancreatic Pseudocyst (diagnostic imaging, surgery)
• Prospective Studies
• Stents
• Treatment Outcome
• Young Adult