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Endoscopy 2019; 51(11): 1035-1043
DOI: 10.1055/a-0759-1353
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Lumen-apposing stents versus plastic stents in the management of pancreatic pseudocysts: a large, comparative, international, multicenter study

Juliana Yang
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Yen-I Chen
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
 2   Division of Gastroenterology and Hepatology, McGill University Health Center, McGill University, Montreal, Québec, Canada
,
Shai Friedland
 3   Division of Gastroenterology, Stanford University School of Medicine, Stanford, California, USA
,
Ian Holmes
 3   Division of Gastroenterology, Stanford University School of Medicine, Stanford, California, USA
,
Christopher Paiji
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Ryan Law
 4   Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
,
Amy Hosmer
 4   Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA
,
Tyler Stevens
 5   Division of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
,
Franco Matheus
 5   Division of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
,
Rishi Pawa
 6   Division of Gastroenterology and Hepatology, Wake Forrest School of Medicine, Winston Salem, North Carolina, USA
,
Nihar Mathur
 6   Division of Gastroenterology and Hepatology, Wake Forrest School of Medicine, Winston Salem, North Carolina, USA
,
Divyesh Sejpal
 7   Division of Gastroenterology and Hepatology, North Shore-Long Island Jewish Health System, New York, New York, USA
,
Sumant Inamdar
 7   Division of Gastroenterology and Hepatology, North Shore-Long Island Jewish Health System, New York, New York, USA
,
Tyler M. Berzin
 8   Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
,
Christopher J. DiMaio
 9   Division of Gastroenterology, Mount Sinai Hospital, New York, New York, USA
,
Sanchit Gupta
 9   Division of Gastroenterology, Mount Sinai Hospital, New York, New York, USA
,
Patrick S. Yachimski
10   Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA
,
Andrea Anderloni
11   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy
,
Alessandro Repici
11   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy
,
Theodore James
12   Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
,
Laith H. Jamil
13   Division of Digestive and Liver Diseases, Cedars Sinai Medical Center, Los Angeles, California, USA
,
Mel Ona
13   Division of Digestive and Liver Diseases, Cedars Sinai Medical Center, Los Angeles, California, USA
,
Simon K. Lo
13   Division of Digestive and Liver Diseases, Cedars Sinai Medical Center, Los Angeles, California, USA
,
Srinivas Gaddam
13   Division of Digestive and Liver Diseases, Cedars Sinai Medical Center, Los Angeles, California, USA
,
Markus Dollhopf
14   Department of Gastroenterology, Klinikum Neuperlach, Munich, Germany
,
Nuha Alammar
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Eugenie Shieh
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Majidah Bukhari
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Vivek Kumbhari
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Vikesh Singh
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Olaya Brewer
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Omid Sanaei
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Lea Fayad
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Saowanee Ngamruengphong
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Eun Ji Shin
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
,
Todd H. Baron
12   Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
,
Mouen A. Khashab
 1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA
› Author Affiliations
Further Information

Publication History

submitted 16 February 2018

accepted after revision 05 September 2018

Publication Date:
07 December 2018 (online)

Also available at
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Corrected by:

Correction: Lumen-apposing stents versus plastic stents in the management of pancreatic pseudocysts: a large, comparative, international, multicenter studyEndoscopy 2019; 51(11): C5-C5
DOI: 10.1055/a-0852-9243

Abstract

Background Larger caliber lumen-apposing stents (LAMSs) have been increasingly used in the management of pancreatic fluid collections, specifically when solid debris is present; however, their advantages over smaller caliber plastic stents in the management of pancreatic pseudocysts are unclear. The aim of this study was to investigate the safety and efficacy of LAMS specifically in the management of pancreatic pseudocysts compared with double-pigtail plastic stents (DPPSs).

Methods We performed a multicenter, international, retrospective study between January 2012 and August 2016. A total of 205 patients with a diagnosis of pancreatic pseudocysts were included, 80 patients received LAMSs and 125 received DPPSs. Measured outcomes included clinical success, technical success, adverse events, stent dysfunction, pancreatic pseudocyst recurrence, and need for surgery.

Results Technical success was similar between the LAMS and the DPPS groups (97.5 % vs. 99.2 %; P = 0.32). Clinical success was higher for LAMSs than for DPPSs (96.3 % vs. 87.2 %; P = 0.03). While the need for surgery was similar between the two groups (1.3 % vs. 4.9 %, respectively; P = 0.17), the use of percutaneous drainage was significantly lower in the LAMS group (1.3 % vs. 8.8 %; P = 0.03). At 6-month follow-up, the recurrence rate was similar between the groups (6.7 % vs 18.8 %, respectively; P = 0.12). The rate of adverse events was significantly higher in the DPPS group (7.5 % vs. 17.6 %; P = 0.04). There was no difference in post-procedure mean length of hospital stay (6.3 days [standard deviation 27.9] vs. 3.7 days [5.7]; P = 0.31).

Conclusion When compared to DPPSs, LAMSs are a safe, feasible, and effective modality for the treatment of pancreatic pseudocysts and are associated with a higher rate of clinical success, shorter procedure time, less need for percutaneous interventions, and a lower overall rate of adverse events.

Table e1

Letter to this article:

Which stent to use for the management of pancreatic pseudocysts? Time for randomized controlled studiesEndoscopy 2020; 52(04): 321-321
DOI: 10.1055/a-1103-1938

 

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