Published online Sep 27, 2019. doi: 10.4240/wjgs.v11.i9.365
Peer-review started: July 14, 2019
First decision: August 2, 2019
Revised: September 3, 2019
Accepted: September 12, 2019
Article in press: September 12, 2019
Published online: September 27, 2019
Current therapeutic techniques for pancreatic pseudocyst include surgical management with a laparoscopic approach or an open surgical procedure, percutaneous catheter drainage and endoscopic drainage. Yet it remains controversial whether different treatment approaches affect inpatient outcome.
To investigate inpatient outcome of different treatment approaches in treating pancreatic pseudocyst.
Here we conducted a retrospective analysis of pancreatic pseudocyst-associated hospitalizations using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample. International Classification of Diseases 10 clinical modification and procedure codes are used.
A total of 7060 patients meeting the above criteria were identified. Our study revealed laparoscopic approach associated with the lowest rate of red blood cell transfusion (P < 0.001), and it had lower short-term complications including acute renal failure (P = 0.01), urinary tract infection (P = 0.01), sepsis (P < 0.001) and acute respiratory failure (P = 0.01). Laparoscopic surgical approach associated with the shortest mean length of stay (P = 0.009), and it had the lowest total charge (P = 0.03). All three modalities have similar inpatient mortality (P = 0.28). The study also revealed that percutaneous drainage associated with more emergent admission (P < 0.001), rural hospital performs the most open surgical drainage (P < 0.001) and patients who received laparoscopic drainage are more likely to be discharged home (P < 0.001).
Laparoscopic drainage of pancreatic pseudocysts associated with the least short-term complications and had better outcomes comparing to percutaneous and open surgical drainage from 2016 National Inpatient Sample database.
Core tip: Pancreatic pseudocyst, the rare clinical entity poses a significant challenge in management given its rarity and lack of evidence suggesting the best managing approach. Most common procedures performed for those patients included open surgical drainage, laparoscopic drainage, radiology guided drainage, and endoscopic drainage. It remains unclear how different treatment modalities affect the outcome of patients with pancreatic pseudocyst. In the present study, we utilized the national inpatient sample to investigate the inpatient outcome of patients who underwent various procedures and provided practical information for clinicians.