scholarly journals Safety and rate of delayed adverse events with lumen-apposing metal stents (LAMS) for pancreatic fluid collections: a multicenter study

2018 ◽  
Vol 06 (10) ◽  
pp. E1267-E1275 ◽  
Author(s):  
Dennis Yang ◽  
Yaseen B. Perbtani ◽  
Lazarus K Mramba ◽  
Tossapol Kerdsirichairat ◽  
Anoop Prabhu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Adverse Events ◽  
Treatment Failure ◽  
Metal Stents ◽  
Endoscopic Drainage ◽  
Stent Occlusion ◽  
Pancreatic Fluid Collections ◽  
Pancreatic Fluid ◽  
Fluid Collections

Abstract Background and study aims Endoscopic drainage with dedicated lumen-apposing metal stents (LAMS) is routinely performed for symptomatic pancreatic fluid collections (PFCs), walled-off necrosis (WON) and pseudocyst (PP). There has been increasing concern regarding delayed adverse events associated with the indwelling LAMS.  Patients and methods Multicenter retrospective analysis of consecutive patients who underwent endoscopic ultrasound (EUS)-guided LAMS placement for PFC from January 2010 to May 2017. Main outcomes included: (1) resolution of the PFC, (2) rate of delayed adverse events at follow-up, and (3) predictors of treatment failure and delayed adverse events on logistic regression. Results A total of 122 patients (mean age 50.9 years, 68 % male) underwent LAMS insertion for 64 WON (98.4 %) and 58 PP (98.3 %). PFC mean size was 10.6 cm. PFC resolution was significantly lower for WON (62.3 %) vs. PP (96.5 %) (P < 0.001) on imaging at a median of 4 weeks. Stent occlusion was identified in 18 (29.5 %) and 10 (17.5 %) patients with WON and PP, respectively (P = 0.13). There were no cases of delayed bleeding or buried stent on follow-up endoscopy. Use of electrocautery-enhanced LAMS was the only factor associated with treatment failure of WON (OR = 13.2; 95 % ci: 3.33 – 51.82, P = 0.02) on logistic regression. There were no patient, operator, or procedure-related factors predictive of stent occlusion. Conclusions EUS-guided LAMS for PFC is associated with a low incidence of delayed adverse events. While nearly all PPs resolve at 4 weeks permitting LAMS removal shortly thereafter, many WON persist, with use of electrocautery-enhanced LAMS being the sole predictor of treatment failure.

268 Low Recurrence RATES After EUS-Guided Drainage of Pancreatic Fluid Collections (PFC) Using Lumen-Apposing Metal Stents (LAMS): a Long-Term Follow-Up Study

2015 ◽  
Vol 81 (5) ◽  
pp. AB130 ◽  
Author(s):  
Carlos De La Serna ◽  
Irene PeñAs ◽  
Fernando Santos Santamarta ◽  
Henar NuñEz ◽  
Pilar Diez-Redondo ◽  
...  
Keyword(s):  
Metal Stents ◽  
Recurrence Rates ◽  
Pancreatic Fluid Collections ◽  
Follow Up Study ◽  
Pancreatic Fluid ◽  
Long Term Follow Up ◽  
Fluid Collections

scholarly journals Are Lumen-Apposing Metal Stents More Effective Than Plastic Stents for the Management of Pancreatic Fluid Collections: An Updated Systematic Review and Meta-analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Shali Tan ◽  
Chunyu Zhong ◽  
Yutang Ren ◽  
Xujuan Luo ◽  
Jin Xu ◽  
...  
Keyword(s):  
Adverse Events ◽  
Clinical Success ◽  
Meta Analysis ◽  
Plastic Stents ◽  
Metal Stents ◽  
Efficacy And Safety ◽  
Technical Success ◽  
Pancreatic Fluid Collections ◽  
Pancreatic Fluid ◽  
Fluid Collections

Background and Aims. Recently, a new type of metal stent, named lumen-apposing metal stents (LAMS), has been designed to manage pancreatic fluid collections (PFC), and a few studies have reported its efficacy and safety. Therefore, we conducted this meta-analysis to investigate the role of LAMS for PFC. Methods. We searched the studies from PubMed, MEDLINE, Embase, and Cochrane databases from inception to May 2019. We extracted the data and analyzed the technical success, clinical success, and adverse events of LAMS to evaluate its efficacy and safety. Results. Twenty studies with 1534 patients were included. The pooled technical success, clinical success, and adverse event rates of LAMS for PFC were 96.2% (95% confidence interval (CI): 94.6%-97.4%), 86.8% (95% CI: 83.1%-89.8%), and 20.7% (95% CI: 16.1%-26.1%), respectively. Eight studies including 875 patients compared the clinical outcomes of LAMS with plastic stents. The pooled risk ratio (RR) of technical success and clinical success for LAMS and plastic stent was 1.01 (95% CI: 0.98-1.04, P=0.62) and 1.06 (95% CI: 1.01-1.12, P=0.03), respectively. As for the overall adverse events, the pooled RR was 1.51 (95% CI: 0.67-3.44, P=0.32). Conclusions. Our current study revealed that LAMS has advantages over plastic stents for PFC, with higher clinical success rate and lower complication rate of infection and occlusion.

scholarly journals Endoscopic Treatment of Pancreatic Fluid Collections

2020 ◽  
Vol 89 (2) ◽  
pp. e443
Author(s):  
Michal Kloska ◽  
Shashin Shah ◽  
Hiral N. Shah
Keyword(s):  
Plastic Stents ◽  
Metal Stents ◽  
Surgical Removal ◽  
Endoscopic Drainage ◽  
First Line ◽  
Pancreatic Fluid Collections ◽  
Pancreatic Fluid ◽  
Fluid Collections ◽  
First Line Treatment ◽  
Necrotic Debris

Acute pancreatitis is frequently complicated by pancreatic fluid collections (PFCs). PFCs usually resolve spontaneously but some can mature forming large cysts filled with fluid or necrotic debris. Historically they have been treated with surgical removal but with the advancement of endoscopic procedures, endoscopic drainage has risen to be a safe first-line treatment of PFCs. Furthermore, the development of plastic stents and lumen apposing metal stents (LAMS) has replaced not only the open surgery but also the percutaneous drainage due to smaller number of adverse events. Especially the LAMS has gained favor recently as large metaanalysis suggests their advantages over plastic stents in the treatment of PFCs, however, the data about their use in the drainage of PFCs is still scarce.

scholarly journals Endoscopic Management of Pancreatic Fluid Collections

2021 ◽  
Vol 10 (2) ◽  
pp. 284
Author(s):  
Robert Dorrell ◽  
Swati Pawa ◽  
Rishi Pawa
Keyword(s):  
Patient Outcomes ◽  
Endoscopic Management ◽  
Metal Stents ◽  
Ultrasound Guided ◽  
Endoscopic Intervention ◽  
Endoscopic Necrosectomy ◽  
Pancreatic Fluid Collections ◽  
Pancreatic Fluid ◽  
Transmural Drainage ◽  
Fluid Collections

Pancreatic fluid collections (PFCs) are a common sequela of pancreatitis. Most PFCs can be managed conservatively, but symptomatic PFCs require either surgical, percutaneous, or endoscopic intervention. Recent advances in the therapeutics of PFCs, including the step-up approach, endoscopic ultrasound-guided transmural drainage with lumen apposing metal stents, and direct endoscopic necrosectomy, have ushered endoscopy to the forefront of PFCs management and have allowed for improved patient outcomes and decreased morbidity. In this review, we explore the progress and future of endoscopic management of PFCs.

Managing adverse events after endoscopic ultrasound‐guided (EUS) drainage of the biliary tract and pancreatic fluid collections: a narrative review (with video)

2021 ◽  
Author(s):  
Mateus Pereira Funari ◽  
Igor Braga Ribeiro ◽  
Marcos Eduardo Lera dos Santos ◽  
Sergio Eiji Matuguma ◽  
Eduardo Guimarães Hourneaux de Moura
Keyword(s):  
Adverse Events ◽  
Biliary Tract ◽  
Endoscopic Ultrasound ◽  
Narrative Review ◽  
Ultrasound Guided ◽  
Pancreatic Fluid Collections ◽  
Pancreatic Fluid ◽  
Fluid Collections
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