TY - JOUR
T1 - A novel lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections
T2 - a prospective cohort study
AU - Walter, Daisy
AU - Will, Uwe
AU - Sanchez-Yague, Andres
AU - Brenke, Dirk
AU - Hampe, Jochen
AU - Wollny, Helge
AU - López-Jamar, Jose Miguel Esteban
AU - Jechart, Gertrud
AU - Vilmann, Peter
AU - Gornals, Joan B
AU - Ullrich, Sebastian
AU - Fähndrich, Martin
AU - de Tejada, Alberto Herreros
AU - Junquera, Félix
AU - Gonzalez-Huix, Ferran
AU - Siersema, Peter D
AU - Vleggaar, Frank P
N1 - © Georg Thieme Verlag KG Stuttgart · New York.
PY - 2015/1/28
Y1 - 2015/1/28
N2 - BACKGROUND AND STUDY AIMS: A novel large-diameter, lumen-apposing, self-expanding metal stent with bilateral flanges was recently developed for endoscopic ultrasound (EUS)-guided transmural drainage of symptomatic pancreatic fluid collections (PFCs). The aim of this study was to evaluate the efficacy and safety of this stent in a large cohort.PATIENTS AND METHODS: Patients with a PFC undergoing EUS-guided drainage with this novel stent were prospectively enrolled in this multicenter cohort study.RESULTS: There were 61 patients: 46 patients (75 %) with walled-off necrosis (WON) and 15 (25 %) with a pancreatic pseudocyst. Stent placement was technically successful in 60 patients (98 %, 95 %CI 95 % - 100 %). Clinical success, defined as resolution of clinical symptoms in combination with a decrease in the PFC size to ≤ 2 cm on imaging, was achieved in 93 % of patients with a pancreatic pseudocyst (95 %CI 77 % - 100 %) and in 81 % of patients with WON (95 %CI 69 % - 94 %). Treatment failure occurred in nine patients (16 %, 95 %CI 6 % - 26 %), including four patients who required surgical intervention. Stent removal was performed in 82 % of patients after a median of 32 days (range 2 - 178) and was rated as easy in all but one patient. In 10 patients, endoscopic stent removal was not performed because of stent migration (n = 3), stent dislodgement during necrosectomy (n = 3), stent removal during surgery (n = 2), or refusal by the patient (n = 2). In total, five major complications were reported (9 %, 95 %CI 2 % - 16 %), including PFC infection (n = 4) and perforation (n = 1).CONCLUSION: EUS-guided drainage using this novel stent is feasible and the clinical results obtained are promising with a low major complication rate.
AB - BACKGROUND AND STUDY AIMS: A novel large-diameter, lumen-apposing, self-expanding metal stent with bilateral flanges was recently developed for endoscopic ultrasound (EUS)-guided transmural drainage of symptomatic pancreatic fluid collections (PFCs). The aim of this study was to evaluate the efficacy and safety of this stent in a large cohort.PATIENTS AND METHODS: Patients with a PFC undergoing EUS-guided drainage with this novel stent were prospectively enrolled in this multicenter cohort study.RESULTS: There were 61 patients: 46 patients (75 %) with walled-off necrosis (WON) and 15 (25 %) with a pancreatic pseudocyst. Stent placement was technically successful in 60 patients (98 %, 95 %CI 95 % - 100 %). Clinical success, defined as resolution of clinical symptoms in combination with a decrease in the PFC size to ≤ 2 cm on imaging, was achieved in 93 % of patients with a pancreatic pseudocyst (95 %CI 77 % - 100 %) and in 81 % of patients with WON (95 %CI 69 % - 94 %). Treatment failure occurred in nine patients (16 %, 95 %CI 6 % - 26 %), including four patients who required surgical intervention. Stent removal was performed in 82 % of patients after a median of 32 days (range 2 - 178) and was rated as easy in all but one patient. In 10 patients, endoscopic stent removal was not performed because of stent migration (n = 3), stent dislodgement during necrosectomy (n = 3), stent removal during surgery (n = 2), or refusal by the patient (n = 2). In total, five major complications were reported (9 %, 95 %CI 2 % - 16 %), including PFC infection (n = 4) and perforation (n = 1).CONCLUSION: EUS-guided drainage using this novel stent is feasible and the clinical results obtained are promising with a low major complication rate.
KW - Adult
KW - Aged
KW - Drainage
KW - Endosonography
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Pancreatic Pseudocyst
KW - Pancreatitis, Acute Necrotizing
KW - Prospective Studies
KW - Stents
KW - Treatment Outcome
KW - Ultrasonography, Interventional
U2 - 10.1055/s-0034-1378113
DO - 10.1055/s-0034-1378113
M3 - Letter
C2 - 25268308
SN - 0013-726X
VL - 47
SP - 63
EP - 67
JO - Endoscopy
JF - Endoscopy
IS - 1
ER -