Pericardioectomy is a very extensive surgery, that almost never removes the entire pericardium. Because of its inherent risks, we almost always precede one of these procedures with a pericardial window, and if it works then the more extensive surgery is avoided.
I don't know much evidence behind the intra-pericardial steriod injection. Certainly at best this is an experimental procedure, and this means this is unproven therapy, which has the possibility of damaging the heart. If oral steroids and a pericardial window control his symptoms, than this is the way to proceed first. Make sure there has been an extensive search for exudative causes of pericarditis, because this could be a life threatening condition such as a myocardial infarction, cancer or pulmonary embolus.
Something else I should have included: my husband's effusions were both very large: 1.5L and 1.0L, respectively.