# Cost-Effectiveness in Alternative Treatment Options for Pancreatic Pseudocysts

## TL;DR

This study compares the cost-effectiveness of different methods for draining pancreatic pseudocysts, showing that a less expensive approach using plastic stents is as effective as more costly alternatives.

## Contribution

The study introduces a cost-effective endoscopic method for pancreatic pseudocyst drainage using plastic stents and standard lavage.

## Key findings

- All four patients had successful outcomes with no long-term complications after 6 months.
- The method using plastic stents was found to be more cost-effective than using lumen-apposing metal stents.
- One acute and one late complication were observed, but overall efficacy was maintained.

## Abstract

Background and Objectives: Pancreatic pseudocysts often arise as complications of pancreatitis and present unique challenges in clinical management, encompassing considerations for both technical aspects and financial implications. Before the advancements of invasive gastroenterology, pancreatic pseudocysts have been drained surgically for many years. Nowadays, we have less invasive techniques with higher efficiency and lower mortality rates, however, they remain cost-challenging for most countries. Materials and Methods: We present four patients (two males and two females) with pancreatic pseudocysts who underwent endoscopic ultrasound-guided transgastric drainage using plastic stents accompanied by a standard lavage protocol using a nasocystic catheter. Results: All four patients had successful outcomes, and a follow-up at 6 months revealed no traces of the pseudocysts or any significant long-term complications. One acute complication (arterial bleeding) and one late complication (stent migration) were observed. As the study aimed to present a cheaper option for draining pancreatic pseudocysts, we investigated and compared costs for the materials we utilized and those associated with lumen-apposing metal stents. Upon compiling the data, a notable advantage was evident in favour of our method. Conclusions: While EUS-guided drainage of pancreatic pseudocysts using lumen-apposing metal stents (LAMSs) represents a high-end strategy for treating pancreatic pseudocysts, our method demonstrates better cost-effectiveness without compromising efficacy.