Endoscopy 2022; 54(07): 706-711
DOI: 10.1055/a-1682-7095
Innovations and brief communications

Novel 15-mm-long lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections located ≥10 mm from the luminal wall

Linda Y. Zhang
 1   Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, United States
,
 2   Department of Surgery, Department of Gastroenterology-Hepatology, Department of Advanced Interventional Endoscopy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
,
Maridi Aerts
 3   Department of Gastroenterology and Hepatology, Universitair Ziekenhuis Brussel (UZB)/Vrije Universiteit Brussel (VUB), Brussels, Belgium
,
Nouredin Messaoudi
 4   Department of Surgery, Universitair Ziekenhuis Brussel (UZB)/Vrije Universiteit Brussel (VUB), Brussels, Belgium
,
Rishi Pawa
 5   Department of Gastroenterology, Wake Forest Baptist Medical Center, Winston Salem, North Carolina, United States
,
Swati Pawa
 5   Department of Gastroenterology, Wake Forest Baptist Medical Center, Winston Salem, North Carolina, United States
,
 6   Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas, Guayaquil, Ecuador
,
Roberto Oleas
 6   Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas, Guayaquil, Ecuador
,
 7   Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States
,
 7   Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, United States
,
Thiruvengadam Muniraj
 8   Department of Gastroenterology and Hepatology, Yale University School of Medicine, New Haven, Connecticut, United States
,
Carlo Fabbri
 9   Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Forli-Cesena, Italy
,
 9   Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Forli-Cesena, Italy
,
Andrea Anderloni
10   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
,
11   Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS – ISMETT, Palermo, Italy
,
Michael Bejjani
 1   Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, United States
,
 1   Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, United States
,
Vikesh Singh
 1   Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, United States
,
Mouen A. Khashab
 1   Department of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, Maryland, United States
› Institutsangaben

Abstract

Background Endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs) by cautery-enhanced lumen-apposing metal stents (LAMS) has largely been limited to collections located < 10 mm from the luminal wall. We present outcomes of the use of a novel 15-mm-long cautery-enhanced LAMS for drainage of PFCs located ≥ 10 mm away.

Methods This international, multicenter study analyzed all adults with PFCs located ≥ 10 mm from the luminal wall who were treated by EUS-guided drainage using the 15-mm-long cautery-enhanced LAMS. The primary outcome was technical success. Secondary outcomes included clinical success (decrease in PFC size by ≥ 50 % at 30 days and resolution of clinical symptoms without surgical intervention), complications, and recurrence.

Results 35 patients (median age 57 years; interquartile range [IQR] 47–64 years; 49 % male) underwent novel LAMS placement for drainage of PFCs (26 walled-off necrosis, 9 pseudocysts), measuring 85 mm (IQR 64–117) maximal diameter and located 11.8 mm (IQR 10–12.3; range 10–14) from the gastric/duodenal wall. Technical and clinical success were high (both 97 %), with recurrence in one patient (3 %) at a median follow-up of 123 days (58–236). Three complications occurred (9 %; one mild, two moderate).

Conclusions The 15-mm-long cautery-enhanced LAMS was feasible and safe for drainage of PFCs located 10–14 mm from the luminal wall.



Publikationsverlauf

Eingereicht: 09. Juni 2021

Angenommen nach Revision: 22. September 2021

Artikel online veröffentlicht:
14. Dezember 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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