Table 1.

Pseudocyst decompression (see text).

Ref	Study design	Participants	Intervention	Results
Endoscopic drainage, surgical drainage, or conservative management of pseudocysts
	Retrospective case series over 16 years (1980–1995), single centre	114 people with pseudocysts, 60% with chronic pancreatitis, 37% alcohol-induced, mean age 48 years, 63% male	Conservative management (68 people, 28% with chronic pancreatitis) v surgery (46 people, 41% with chronic pancreatitis). Types of surgery performed: percutaneous drainage (13%), surgical drainage (57%), resection (17%). 13% had aspiration only	Conservative management: Success rates: 43/68 (63%) at median 51 months Resolution of cyst in people successfully managed conservatively: 13/43 (30%) at mean 46 months Emergency surgery: 5/68 (8%) at median 51 months Elective surgery: 19/68 (28%) at median 51 months Mortality: 0% at median 51 months Surgery (percutaneous or surgical drainage): Postoperative complications: 67% with percutaneous drainage (fistula/abscess), 20% with surgical drainage (bleeding, infection) Recurrence/persistent pseudocyst: 32% (11% with symptomatic pseudocysts) after median follow-up of 40 months. Results not calculable for each type of surgery Mortality: 0% at median 40 months
	Retrospective case series over 6 years (1993–1999), multicentre	38 people with pseudocysts, 12 (31%) with alcohol-related chronic pancreatitis, 65% male	Endoscopic drainage	Disappearance of cyst at 3 months: 100% Recurrence over mean 44 months: 16% (all in people with alcohol-related chronic pancreatitis) Postoperative complications: 13% Mortality over mean 44 months: 0%
	Retrospective case series over 11 years (dates not reported), single centre	36 people with pseudocysts, 12 (33%) with chronic pancreatitis, 3 alcohol-induced, median age 55 years, 52% male	Conservative management v endoscopic drainage v surgical drainage	Conservative management: Success rates: 14/36 (39%), 9 with chronic pancreatitis over mean 37.6 months Recurrence: 1/14 (7%) Endoscopic drainage: Carried out for 12/36 (33%) people Success rates: 10/36 (28%) Recurrence: 2/36 (5%) Complications: 0/36 (0%) Surgical drainage: Carried out for 10/36 (28%) people Success rates: 10/36 (28%) Recurrence: 0/36 (0%) Complications: 3/36 (8%), 2 developed abscesses, 1 developed pulmonary embolism
	Retrospective case series over 2 years (dates not reported), single centre	34 people with pseudocysts (27 evaluated), median age 38 years, 79% male, 59% with chronic pancreatitis over 2 years, 56% alcohol-induced	Endoscopic drainage	Initial success: 24/34 (71%) Recurrence: 3/34 (9%). Factors associated with failure: >1 cm wall thickness, location of pseudocysts in tail of pancreas Success at median 46 months: 21/34 (62%)
	Retrospective case series over 17 years (1983–2000), single centre	92 people with pseudocysts, median age 49 years, 72% male, 70% with chronic pancreatitis with a median 9 months of disease, 50% with alcohol-induced pancreatitis	Endoscopic drainage	Absence of cyst at a median 43 months (success rates): 71% Multivariate analysis suggested higher success rates if pseudocysts were located in the pancreatic head as compared with body/tail (OR 0.17, 95% CI 0.05 to 0.60), drainage duration of >6 weeks' duration (OR 0.19, 95% CI 0.06 to 0.60), and drainage with multiple rather than single stents (OR 0.08, 95% CI 0.01 to 0.79) Postoperative complications: 34% (common complications included bleeding and infection) Mortality at 60 days (procedure-related): 1%
Different types of surgical pseudocyst decompression versus each other
	Retrospective case series over 15 years (1975–89), single centre	98 people with pseudocysts, 67 with alcohol-induced pancreatitis, mean age 45–49 years, 82% male	CG (39 people) v CJ (59 people). Short-term follow-up (postoperative, not specified, up to 116 days, longest duration in range) and long-term follow-up (up to 4 years after surgery)	Note: People having CG had significantly larger cysts than those having CJ: 11.1 cm with CG v 6.7 cm with CJ; P <0.005 Length of operation: Significantly shorter with CG compared with CJ: 148 minutes with CG v 265 minutes with CJ; P <0.05 Intraoperative blood loss: Significantly lower with CG compared with CJ: 397 mL with CG v 703 mL with CJ; P <0.05 Postoperative haemorrhage: Higher with CG than CJ: 8% with CG v 2% with CJ; significance not assessed Overall complications: 10% with CG v 12% with CJ; significance not assessed Length of hospital stay: 11.3 days with CG v 18.9 days with CJ; P value reported as not significant Perioperative mortality: Similar rates: 5% with CG v 3% with CJ; significance not assessed Recurrence: 10% with CG v 7% with CJ at 4–6 years; significance not assessed

CG, cystogastrostomy; CJ, cystojejunostomy; Ref, reference.