EUS-guided drainage of postsurgical fluid collections using lumen-apposing metal stents: A multicenter study

Prashant R. Mudireddy, Amrita Sethi, Ali A. Siddiqui, Douglas G. Adler, Jose Nieto, Harshit Khara, Arvind Trindade, Sammy Ho, Petros C. Benias, Peter V. Draganov, Dennis Yang, Shaffer Mok, Bradley Confer, David L. Diehl

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background and Aims: Postsurgical fluid collections (PSFCs) are traditionally drained either percutaneously or surgically. Endoscopic drainage offers several advantages compared with either percutaneous or surgical approaches, including avoiding repeat surgery or the need to have a percutaneous drain in place for weeks. There are very little data regarding the use of lumen-apposing metal stents (LAMSs) in the drainage of PSFCs. We aim to study the technical and clinical success and adverse events (AEs) of using LAMSs in the drainage of PSFCs. Methods: Collaborators from 8 centers retrospectively reviewed their endoscopic databases to find procedures using LAMSs for drainage of PSFCs. Technical success (successful placement of LAMSs into the fluid collection), clinical success (complete resolution of the fluid collection on repeat imaging or endoscopy), and intraprocedure and postprocedure AEs were measured. Results: Forty-seven patients were identified with PSFCs after various surgeries. Thirteen patients had failed previous percutaneous or surgical drainage attempts. Fluid collections averaged 78.6 mm (range, 47-150 mm) in size. The most common site of stent placement was transgastric, followed by rectum and duodenum. Technical success rate was 93.6% and clinical success rate 89.3%. The intraprocedural AE rate was 4.25% and postprocedural AE rate 6.4%. There was 1 death unrelated to the procedure. Conclusions: The use of LAMSs to drain PSFCs has a high technical and clinical success rate with low AEs. For collections that are favorably located adjacent to the stomach, duodenum, or rectum, LAMS placement is a viable alternative to repeat surgery or percutaneous drainage.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
DOIs
StateAccepted/In press - Jan 1 2017

Fingerprint

Multicenter Studies
Stents
Drainage
Metals
Reoperation
Duodenum
Rectum
Endoscopy
Stomach
Databases

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Mudireddy, P. R., Sethi, A., Siddiqui, A. A., Adler, D. G., Nieto, J., Khara, H., ... Diehl, D. L. (Accepted/In press). EUS-guided drainage of postsurgical fluid collections using lumen-apposing metal stents: A multicenter study. Gastrointestinal Endoscopy. https://doi.org/10.1016/j.gie.2017.08.011

EUS-guided drainage of postsurgical fluid collections using lumen-apposing metal stents : A multicenter study. / Mudireddy, Prashant R.; Sethi, Amrita; Siddiqui, Ali A.; Adler, Douglas G.; Nieto, Jose; Khara, Harshit; Trindade, Arvind; Ho, Sammy; Benias, Petros C.; Draganov, Peter V.; Yang, Dennis; Mok, Shaffer; Confer, Bradley; Diehl, David L.

In: Gastrointestinal Endoscopy, 01.01.2017.

Research output: Contribution to journalArticle

Mudireddy, PR, Sethi, A, Siddiqui, AA, Adler, DG, Nieto, J, Khara, H, Trindade, A, Ho, S, Benias, PC, Draganov, PV, Yang, D, Mok, S, Confer, B & Diehl, DL 2017, 'EUS-guided drainage of postsurgical fluid collections using lumen-apposing metal stents: A multicenter study', Gastrointestinal Endoscopy. https://doi.org/10.1016/j.gie.2017.08.011
Mudireddy, Prashant R. ; Sethi, Amrita ; Siddiqui, Ali A. ; Adler, Douglas G. ; Nieto, Jose ; Khara, Harshit ; Trindade, Arvind ; Ho, Sammy ; Benias, Petros C. ; Draganov, Peter V. ; Yang, Dennis ; Mok, Shaffer ; Confer, Bradley ; Diehl, David L. / EUS-guided drainage of postsurgical fluid collections using lumen-apposing metal stents : A multicenter study. In: Gastrointestinal Endoscopy. 2017.
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AU - Mudireddy, Prashant R.

AU - Sethi, Amrita

AU - Siddiqui, Ali A.

AU - Adler, Douglas G.

AU - Nieto, Jose

AU - Khara, Harshit

AU - Trindade, Arvind

AU - Ho, Sammy

AU - Benias, Petros C.

AU - Draganov, Peter V.

AU - Yang, Dennis

AU - Mok, Shaffer

AU - Confer, Bradley

AU - Diehl, David L.

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N2 - Background and Aims: Postsurgical fluid collections (PSFCs) are traditionally drained either percutaneously or surgically. Endoscopic drainage offers several advantages compared with either percutaneous or surgical approaches, including avoiding repeat surgery or the need to have a percutaneous drain in place for weeks. There are very little data regarding the use of lumen-apposing metal stents (LAMSs) in the drainage of PSFCs. We aim to study the technical and clinical success and adverse events (AEs) of using LAMSs in the drainage of PSFCs. Methods: Collaborators from 8 centers retrospectively reviewed their endoscopic databases to find procedures using LAMSs for drainage of PSFCs. Technical success (successful placement of LAMSs into the fluid collection), clinical success (complete resolution of the fluid collection on repeat imaging or endoscopy), and intraprocedure and postprocedure AEs were measured. Results: Forty-seven patients were identified with PSFCs after various surgeries. Thirteen patients had failed previous percutaneous or surgical drainage attempts. Fluid collections averaged 78.6 mm (range, 47-150 mm) in size. The most common site of stent placement was transgastric, followed by rectum and duodenum. Technical success rate was 93.6% and clinical success rate 89.3%. The intraprocedural AE rate was 4.25% and postprocedural AE rate 6.4%. There was 1 death unrelated to the procedure. Conclusions: The use of LAMSs to drain PSFCs has a high technical and clinical success rate with low AEs. For collections that are favorably located adjacent to the stomach, duodenum, or rectum, LAMS placement is a viable alternative to repeat surgery or percutaneous drainage.

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