EUS-guided drainage of pancreatic fluid collections using lumen apposing metal stents: An international, multicenter experience

Nikhil A. Kumta, Amy Tyberg, Vicky H. Bhagat, Ali A. Siddiqui, Thomas E. Kowalski, David E. Loren, Amit P. Desai, Alex M. Sarkisian, Elizabeth G. Brown, Kunal Karia, Monica Gaidhane, Prashant Kedia, Paul R. Tarnasky, Umangi Patel, Douglas Adler, Linda J. Taylor, Maria Petrone, Paolo Arcidiacono, Patrick S. Yachimski, Douglas WeineSubha Sundararajan, Pierre H. Deprez, Christina Mouradides, Sammy Ho, Safeera Javed, Jeffrey J. Easler, Isaac Raijman, Enrique Vazquez-Sequeiros, Mandeep Sawhney, Tyler M. Berzin, Michel Kahaleh

Research output: Contribution to journalArticle

Abstract

Introduction: Lumen apposing metal stents (LAMS) have been used increasingly for drainage of pancreatic fluid collections (PFC). We present an international, multicenter study evaluating the safety and efficacy of LAMS in PFCs. Methods: Consecutive patients undergoing LAMS placement for PFC at 12 international centers were included (ClinicalTrials.gov NCT01522573). Demographics, clinical history, and procedural details were recorded. Technical success was defined as successful LAMS deployment. Clinical success was defined as PFC resolution at three-month follow-up. Results: 192 patients were included (140 males (72.9%), mean-age 53.8 years), with mean follow-up of 4.2 months ± 3.8. Mean PFC size was 11.9 cm (range 2–25). The median number of endoscopic interventions was 2 (range 1–14). Etiologies for PFC were gallstone (n = 82, 42.7%), alcohol (n = 50, 26%), idiopathic (n = 26, 13.5%), and other (n = 34, 17.7%). Technical success was achieved in 189 patients (98.4%). Clinical success was observed in 125 of 135 patients (92.6%). Adverse events included bleeding (n = 11, 5.7), infection (n = 2, 1%), and perforation (n = 2, 1%). Three or more endoscopy sessions were a positive predictor for PFC resolution and the only significant predictor for AEs. Conclusion: LAMS has a high technical and clinical success rate with a low rate of AEs. PFC drainage via LAMS provides a minimally invasive, safe, and efficacious procedure for PFC resolution.

Original languageEnglish (US)
JournalDigestive and Liver Disease
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Stents
Drainage
Metals
Gallstones
Endoscopy
Multicenter Studies
Alcohols
Demography
Hemorrhage
Safety
Infection

Keywords

  • EUS-guided drainage
  • LAMs
  • Lumen apposing stent
  • Pancreatic fluid collection
  • Pancreatic pseudocyst
  • PFC
  • Walled-off necrosis
  • WON

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

EUS-guided drainage of pancreatic fluid collections using lumen apposing metal stents : An international, multicenter experience. / Kumta, Nikhil A.; Tyberg, Amy; Bhagat, Vicky H.; Siddiqui, Ali A.; Kowalski, Thomas E.; Loren, David E.; Desai, Amit P.; Sarkisian, Alex M.; Brown, Elizabeth G.; Karia, Kunal; Gaidhane, Monica; Kedia, Prashant; Tarnasky, Paul R.; Patel, Umangi; Adler, Douglas; Taylor, Linda J.; Petrone, Maria; Arcidiacono, Paolo; Yachimski, Patrick S.; Weine, Douglas; Sundararajan, Subha; Deprez, Pierre H.; Mouradides, Christina; Ho, Sammy; Javed, Safeera; Easler, Jeffrey J.; Raijman, Isaac; Vazquez-Sequeiros, Enrique; Sawhney, Mandeep; Berzin, Tyler M.; Kahaleh, Michel.

In: Digestive and Liver Disease, 01.01.2019.

Research output: Contribution to journalArticle

Kumta, NA, Tyberg, A, Bhagat, VH, Siddiqui, AA, Kowalski, TE, Loren, DE, Desai, AP, Sarkisian, AM, Brown, EG, Karia, K, Gaidhane, M, Kedia, P, Tarnasky, PR, Patel, U, Adler, D, Taylor, LJ, Petrone, M, Arcidiacono, P, Yachimski, PS, Weine, D, Sundararajan, S, Deprez, PH, Mouradides, C, Ho, S, Javed, S, Easler, JJ, Raijman, I, Vazquez-Sequeiros, E, Sawhney, M, Berzin, TM & Kahaleh, M 2019, 'EUS-guided drainage of pancreatic fluid collections using lumen apposing metal stents: An international, multicenter experience', Digestive and Liver Disease. https://doi.org/10.1016/j.dld.2019.05.033
Kumta, Nikhil A. ; Tyberg, Amy ; Bhagat, Vicky H. ; Siddiqui, Ali A. ; Kowalski, Thomas E. ; Loren, David E. ; Desai, Amit P. ; Sarkisian, Alex M. ; Brown, Elizabeth G. ; Karia, Kunal ; Gaidhane, Monica ; Kedia, Prashant ; Tarnasky, Paul R. ; Patel, Umangi ; Adler, Douglas ; Taylor, Linda J. ; Petrone, Maria ; Arcidiacono, Paolo ; Yachimski, Patrick S. ; Weine, Douglas ; Sundararajan, Subha ; Deprez, Pierre H. ; Mouradides, Christina ; Ho, Sammy ; Javed, Safeera ; Easler, Jeffrey J. ; Raijman, Isaac ; Vazquez-Sequeiros, Enrique ; Sawhney, Mandeep ; Berzin, Tyler M. ; Kahaleh, Michel. / EUS-guided drainage of pancreatic fluid collections using lumen apposing metal stents : An international, multicenter experience. In: Digestive and Liver Disease. 2019.
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abstract = "Introduction: Lumen apposing metal stents (LAMS) have been used increasingly for drainage of pancreatic fluid collections (PFC). We present an international, multicenter study evaluating the safety and efficacy of LAMS in PFCs. Methods: Consecutive patients undergoing LAMS placement for PFC at 12 international centers were included (ClinicalTrials.gov NCT01522573). Demographics, clinical history, and procedural details were recorded. Technical success was defined as successful LAMS deployment. Clinical success was defined as PFC resolution at three-month follow-up. Results: 192 patients were included (140 males (72.9{\%}), mean-age 53.8 years), with mean follow-up of 4.2 months ± 3.8. Mean PFC size was 11.9 cm (range 2–25). The median number of endoscopic interventions was 2 (range 1–14). Etiologies for PFC were gallstone (n = 82, 42.7{\%}), alcohol (n = 50, 26{\%}), idiopathic (n = 26, 13.5{\%}), and other (n = 34, 17.7{\%}). Technical success was achieved in 189 patients (98.4{\%}). Clinical success was observed in 125 of 135 patients (92.6{\%}). Adverse events included bleeding (n = 11, 5.7), infection (n = 2, 1{\%}), and perforation (n = 2, 1{\%}). Three or more endoscopy sessions were a positive predictor for PFC resolution and the only significant predictor for AEs. Conclusion: LAMS has a high technical and clinical success rate with a low rate of AEs. PFC drainage via LAMS provides a minimally invasive, safe, and efficacious procedure for PFC resolution.",
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T1 - EUS-guided drainage of pancreatic fluid collections using lumen apposing metal stents

T2 - An international, multicenter experience

AU - Kumta, Nikhil A.

AU - Tyberg, Amy

AU - Bhagat, Vicky H.

AU - Siddiqui, Ali A.

AU - Kowalski, Thomas E.

AU - Loren, David E.

AU - Desai, Amit P.

AU - Sarkisian, Alex M.

AU - Brown, Elizabeth G.

AU - Karia, Kunal

AU - Gaidhane, Monica

AU - Kedia, Prashant

AU - Tarnasky, Paul R.

AU - Patel, Umangi

AU - Adler, Douglas

AU - Taylor, Linda J.

AU - Petrone, Maria

AU - Arcidiacono, Paolo

AU - Yachimski, Patrick S.

AU - Weine, Douglas

AU - Sundararajan, Subha

AU - Deprez, Pierre H.

AU - Mouradides, Christina

AU - Ho, Sammy

AU - Javed, Safeera

AU - Easler, Jeffrey J.

AU - Raijman, Isaac

AU - Vazquez-Sequeiros, Enrique

AU - Sawhney, Mandeep

AU - Berzin, Tyler M.

AU - Kahaleh, Michel

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: Lumen apposing metal stents (LAMS) have been used increasingly for drainage of pancreatic fluid collections (PFC). We present an international, multicenter study evaluating the safety and efficacy of LAMS in PFCs. Methods: Consecutive patients undergoing LAMS placement for PFC at 12 international centers were included (ClinicalTrials.gov NCT01522573). Demographics, clinical history, and procedural details were recorded. Technical success was defined as successful LAMS deployment. Clinical success was defined as PFC resolution at three-month follow-up. Results: 192 patients were included (140 males (72.9%), mean-age 53.8 years), with mean follow-up of 4.2 months ± 3.8. Mean PFC size was 11.9 cm (range 2–25). The median number of endoscopic interventions was 2 (range 1–14). Etiologies for PFC were gallstone (n = 82, 42.7%), alcohol (n = 50, 26%), idiopathic (n = 26, 13.5%), and other (n = 34, 17.7%). Technical success was achieved in 189 patients (98.4%). Clinical success was observed in 125 of 135 patients (92.6%). Adverse events included bleeding (n = 11, 5.7), infection (n = 2, 1%), and perforation (n = 2, 1%). Three or more endoscopy sessions were a positive predictor for PFC resolution and the only significant predictor for AEs. Conclusion: LAMS has a high technical and clinical success rate with a low rate of AEs. PFC drainage via LAMS provides a minimally invasive, safe, and efficacious procedure for PFC resolution.

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