title: A comparative evaluation of outcomes of endoscopic versus percutaneous drainage for symptomatic pancreatic pseudocysts.
abstract: BACKGROUND
  Endoscopic drainage (ED) and percutaneous drainage (PD) have largely replaced surgical drainage as the initial approach for symptomatic pseudocysts. However, there are few studies comparing ED and PD.
  
  
  OBJECTIVE
  To compare the outcomes of ED and PD for symptomatic pseudocysts.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Academic center.
  
  
  METHODS
  Adult patients with symptomatic pseudocysts within ≤ 1 cm of the gastric or duodenal wall who underwent ED or PD between 1993 and 2011. Patients with walled-off pancreatic necrosis were excluded.
  
  
  METHODS
  ED or PD.
  
  
  METHODS
  Rates of technical success, procedural adverse events, clinical success, reinterventions, and failure. Other outcomes included the length of hospital stay and number of follow-up abdominal imaging studies.
  
  
  RESULTS
  There were 81 patients, 41 who underwent ED and 40 who underwent PD, with no differences in age, sex, and comorbidity between the 2 groups. There were no differences in the rates of technical success (90.2% vs 97.5%; P = .36), adverse events (14.6% vs 15%; P = .96), and clinical success (70.7% vs 72.5%; P = .86) between ED and PD, respectively. Patients who underwent PD had higher rates of reintervention (42.5% vs 9.8%; P = .001), longer length of hospital stay (14.8 ± 14.4 vs 6.5 ± 6.7 days; P = .001), and median number [quartiles] of follow-up abdominal imaging studies (6 [3.25, 10] vs 4 [2.5, 6]; P = .02) compared with patients who underwent ED.
  
  
  CONCLUSIONS
  Single center, retrospective study.
  
  
  CONCLUSIONS
  ED and PD have similar clinical success rates for symptomatic pseudocysts. However, PD is associated with significantly higher rates of reintervention, longer length of hospital stay, and increased number of follow-up abdominal imaging studies.
authors: Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Venkata S
authors: VS
authors: Akshintala
authors: Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Payal
authors: P
authors: Saxena
authors: Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Atif
authors: A
authors: Zaheer
authors: Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Uzma
authors: U
authors: Rana
authors: Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Susan M
authors: SM
authors: Hutfless
authors: Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Anne Marie
authors: AM
authors: Lennon
authors: Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Marcia I
authors: MI
authors: Canto
authors: Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Anthony N
authors: AN
authors: Kalloo
authors: Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Mouen A
authors: MA
authors: Khashab
authors: Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors: Vikesh K
authors: VK
authors: Singh
mesh_terms: D004322:Drainage / Q000379:methods*; D004384:Duodenoscopy / Q000379:methods*; D019160:Endosonography; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome