Abstract: Objective To investigate the clinical effect of laparoscopic internal drainage of pancreatic pseudocyst ( LIDP) versus open surgical internal drainage of pancreatic pseudocyst ( OSIDP) and the feasibility, safety, and superiority of LIDP. Methods A retrospective analysis was performed for the clinical data of 46 patients with pancreatic pseudocyst ( PPC) who underwent internal drainage in China-Japan Union Hospital of Jilin University and The Second Hospital of Jilin University from June 2011 to August 2016, and among these patients, 22 underwent LIDP ( LIDP group) and 24 underwent OSIDP ( OSIDP group) . The two groups were compared in terms of preoperative general status ( sex, age, and size of the cyst) , intraoperative conditions ( time of operation and intraoperative blood loss) , and postoperative conditions ( time to first flatus, time to first meal, length of postoperative hospital stay, hospital cost, and complications) . The t-test was used for comparison of normally distributed continuous data with homogeneity of variance between groups, and the t'test was used for continuous data with heterogeneity of variance; the Pearson chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results There were significant differences between the two groups in intraoperative blood loss ( 87. 72 ± 24. 48 ml vs 103. 75 ±26. 83 ml, P < 0. 05) , time to first flatus after surgery ( 3. 00 ± 1. 02 d vs 3. 79 ± 1. 10 d, t =-2. 517, P = 0. 016) , time to first meal after surgery ( 3. 09 ± 0. 97 d vs 3. 87 ± 0. 99 d, t =-2. 705, P = 0. 010) , length of postoperative hospital stay ( 4. 90 ± 1. 54 d vs 8. 66 ± 3. 71 d, t =-4. 548, P < 0. 001) , and hospital cost ( 43 402. 06 ± 6424. 47 yuan vs 37 668. 45 ± 11 249. 01 yuan, t = 2. 097, P = 0. 042) . Of all 22 patients in the LIDP group, 2 ( 9. 09%) experienced the postoperative complication of biochemical leakage; of all 24 patients in the OSIDP group, 4 ( 16. 67%) experienced postoperative complications ( 2 patients with biochemical leakage and 2 with grade B pancreatic fistula) , among whom 2 patients were complicated by bleeding. Conclusion LIDP has the advantages of small trauma, clear visual field, low intraoperative blood loss, fast postoperative recovery, short length of hospital stay, and low incidence of complications. Compared with OSIDP, LIDP does not increase the time of operation, but it leads to a significant increase in average hospital cost. This surgical procedure is simple and easy and does not have high requirements for surgical equipment, and therefore, it holds promise for clinical application.