Endoscopic versus surgical treatment for pancreatic pseudocyst

Abstract

Background and aim: To evaluate the effectiveness and safety of endoscopic treatment for pancreatic pseudocyst compared with surgical treatment.

Methods: PubMed and The Cochrane Library were systematically searched to identify all comparative trials investigating endoscopic versus surgical treatment for pancreatic pseudocyst. Main outcome measures included treatment success rate, adverse events, recurrence rate, length of hospital stay and hospital cost.

Results: Five comparative studies with 255 participants were included in this meta-analysis. The surgical group exhibited a higher treatment success rate than the endoscopic group (OR, 0.43; 95% CI, 0.20-0.95; P = 0.04). However, there was no difference in the rates of adverse events (OR, 0.67; 95% CI, 0.33-1.36; P = 0.27) or recurrence (OR, 1.53; 95% CI, 0.37-6.39; P = 0.56) between the endoscopic and the surgical groups. Evidence from included studies demonstrated that the endoscopic group was associated with shorter length of hospital stay and lower hospital cost compared to the surgical group.

Conclusion: Endoscopic treatment may be the first-line treatment approach for patients with pancreatic pseudocyst.

Keywords: endoscopy; meta-analysis; pancreatic pseudocyst; surgery; treatment.