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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(01): E6-E12
DOI: 10.1055/a-1031-9295
Original article
Owner and Copyright © Georg Thieme Verlag KG 2020

Lumen-apposing metal stents versus biliary fully-covered metal stents for EUS-guided drainage of pancreatic fluid collections: a case control study

Meeting presentations: European Society of Gastrointestinal Endoscopy ESGE Days 2018
Ana Garcia Garcia de Paredes
1   Gastroenterology and Hepatology Department. Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
,
Juan Angel Gonzalez Martin
1   Gastroenterology and Hepatology Department. Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
,
Jose Ramon Foruny Olcina
1   Gastroenterology and Hepatology Department. Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
,
Diego Juzgado Lucas
2   Department of Gastroenterology. Hospital Universitario Quiron Madrid. Madrid, Spain
,
Fernando Gonzalez Panizo
2   Department of Gastroenterology. Hospital Universitario Quiron Madrid. Madrid, Spain
,
Sergio Lopez Duran
1   Gastroenterology and Hepatology Department. Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
,
Alba Martinez Sanchez
1   Gastroenterology and Hepatology Department. Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
,
Alfonso Sanjuanbenito
3   Surgery Department. Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
,
Alejandra Caminoa
4   Pathology Department. Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
,
Agustin Albillos
1   Gastroenterology and Hepatology Department. Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
,
Enrique Vazquez-Sequeiros
1   Gastroenterology and Hepatology Department. Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
› Author Affiliations
Further Information

Publication History

submitted 27 March 2019

accepted after revision 06 August 2019

Publication Date:
08 January 2020 (online)

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Abstract

Background and study aims Endoscopic ultrasound (EUS)-guided drainage has become first-line treatment for pancreatic fluid collections (PFC). The aim of this study was to compare the effectiveness and safety of biliary fully-covered self-expandable metal stents (BFCSEMS) and lumen-apposing metal stents with electrocautery (EC-LAMS).

Patients and methods From April 2008 to March 2017, consecutive patients with symptomatic PFC drained under EUS-guidance with metal stents were included. Patients drained with EC-LAMS were considered the study group and those drained with BFCSEMS the control group. Two primary endpoints were evaluated: effectiveness (defined as reduction of ≥ 50 % of PFC size in cross-sectional imaging and improvement of symptoms 6 months after the transmural drainage) and safety.

Results Thirty patients were drained with EC-LAMS and 60 patients with BFCSEMS. Patients and PFC baseline characteristics in both groups were similar. Use of a coaxial double pigtail plastic stent and a nasocystic lavage catheter was significantly less frequent in patients drained with EC-LAMS (33 % vs. 100 %, and 13 % vs. 58 %, respectively; P < 0.0001). Technical success was 100 % in both groups. Procedure time was < 30 minutes in all patients drained with EC-LAMS and over 30 minutes in all patients drained with BFCSEMS (P = 0.0001). Clinical success was higher with a tendency to significance in patients drained with EC-LAMS (96 % vs. 82 %, P = 0.055) and the adverse event rate was lower (4 % vs. 18 %, P = 0.04). No case of procedure-related mortality was recorded.

Conclusions EC-LAMS and BFCSEMS are both effective for EUS-guided drainage of PFC. However, EC-LAMS requires less time to be performed and appears to be safer.

 

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