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Pancreatic pseudocysts can be drained surgically or endoscopically. In this first randomized trial in which the two approaches were compared, researchers at a single center assigned 40 patients with pseudocysts to undergo cystogastrostomy either by open surgery or by endoscopy (with endoscopic ultrasound). Enrollment criteria included pseudocyst ≥6 cm in size and adjacent to the stomach, persistent pain, and symptomatic gastric or bile duct obstruction by the pseudocyst. Patients in the endoscopic group also underwent stenting at sites of pancreatic duct leaks.
During 2 years of follow-up, no pseudocysts recurred in the endoscopy group, and one recurred in the surgery group (1 endoscopy patient required 2 procedures). Total costs were signif…