Faculty Collaboration Database

Safety and efficacy of lumen-apposing metal stents with and without simultaneous double-pigtail plastic stents for draining pancreatic pseudocyst. Gastrointest Endosc 2018 May;87(5):1248-1255

Date

12/14/2017

Pubmed ID

29233670

DOI

10.1016/j.gie.2017.11.033

Scopus ID

2-s2.0-85043785665 (requires institutional sign-in at Scopus site)   51 Citations

Abstract

BACKGROUND AND AIMS: Lumen-apposing metal stents (LAMSs) are used to perform necrosectomy in walled-off necrosis (WON). Although necrosectomy is not required for pancreatic pseudocyst (PP), an increasing number of PPs are also being drained with LAMSs in view of their ease of deployment. The aim of the present study was to evaluate the safety and efficacy of using LAMSs to drain PPs.

METHODS: At 1 tertiary center from January 2014 to May 2016, all consecutive patients with PPs were drained by LAMSs, and the data were retrospectively reviewed. After observing cyst-cavity infection in patients enrolled initially (group I), 10F double-pigtail stents (DPSs) were placed across LAMSs in the subsequent patients (group II). Data on technical success, PP resolution, adverse events, and reintervention rates were collected.

RESULTS: Forty-seven patients with PPs (mean size, 9.5 ± 4.0 cm) were enrolled (group I, 24; group II, 23). There was 1 perforation at deployment (technical success, 98%). In the remaining 46 patients, resolution of the PP was observed in 44 patients (96%). Four patients (17%) in group I presented with PP infection requiring reinterventions. Food material was observed in the cyst cavity. None of the patients in group II had PP infection (relative risk, .84; 95% confidence interval, .71-1.0; P = .054).

CONCLUSIONS: Similar to WON, LAMSs are also effective in endoscopic drainage of PPs. However, there was a trend toward higher PP infection with LAMSs, and placing a DPS across the LAMS minimized this risk.

Author List

Aburajab M, Smith Z, Khan A, Dua K

Authors

Kulwinder S. Dua MD Professor in the Medicine department at Medical College of Wisconsin
Zachary Smith DO Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Drainage
Endoscopy, Digestive System
Female
Humans
Male
Metals
Middle Aged
Necrosis
Pancreas
Pancreatic Pseudocyst
Plastics
Retrospective Studies
Stents
Treatment Outcome