TY - JOUR
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
N1 - Publisher Copyright:
© 2019 Editrice Gastroenterologica Italiana S.r.l.
PY - 2019/11
Y1 - 2019/11
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.
AB - 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.
KW - EUS-guided drainage
KW - LAMs
KW - Lumen apposing stent
KW - PFC
KW - Pancreatic fluid collection
KW - Pancreatic pseudocyst
KW - WON
KW - Walled-off necrosis
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U2 - 10.1016/j.dld.2019.05.033
DO - 10.1016/j.dld.2019.05.033
M3 - Article
C2 - 31272934
AN - SCOPUS:85068095334
SN - 1590-8658
VL - 51
SP - 1557
EP - 1561
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
IS - 11
ER -