title: Single-step versus 2-step management of huge pancreatic pseudocysts: a prospective randomized trial with long-term follow-up.
abstract: OBJECTIVE
  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: From the *Department of Minimally Invasive Surgery, Tianjin Nankai Hospital, Tianjin; †Department of Pancreatic Surgery, General Hospital of Chinese People's Liberation Army, Beijing; and ‡Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.
authors: Haicheng
authors: H
authors: Yuan
authors: Mingfang
authors: M
authors: Qin
authors: Rong
authors: R
authors: Liu
authors: Sanyuan
authors: S
authors: Hu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult