Endoscopic ultrasound-guided pancreatic fluid collections' transmural drainage outcomes in 100 consecutive cases of pseudocysts and walled off necrosis: a single-centre experience from the United Kingdom

2017 ◽  
Vol 53 (5) ◽  
pp. 611-615 ◽  
Author(s):  
Chander Shekhar ◽  
Ben Maher ◽  
Colm Forde ◽  
Brinder Singh Mahon
Keyword(s):  
United Kingdom ◽  
Ultrasound Guided ◽  
Single Centre ◽  
Pancreatic Fluid Collections ◽  
The United Kingdom ◽  
Pancreatic Fluid ◽  
Single Centre Experience ◽  
Transmural Drainage ◽  
Fluid Collections ◽  
Walled Off Necrosis

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.

scholarly journals Performance Characteristics of a Lumen-Apposing Metal Stent for Pancreatic Fluid Collections: A Prospective Cohort Study

2020 ◽  
Author(s):  
Amit Dhillon ◽  
Suqing Li ◽  
Simrat Sandha ◽  
Pernilla D’Souza ◽  
Gurpal Sandha
Keyword(s):  
Cohort Study ◽  
Clinical Success ◽  
Performance Characteristics ◽  
Procedure Time ◽  
Technical Success ◽  
Ultrasound Guided ◽  
Pancreatic Fluid Collections ◽  
Pancreatic Fluid ◽  
Fluid Collections ◽  
Walled Off Necrosis

Abstract Background Endoscopic ultrasound-guided transmural drainage is the preferred management of pancreatic fluid collections (PFCs). Optimizing drainage is important and there remains debate as to the choice of stent. A recent trend towards the use of lumen-apposing metal stents (LAMS) has emerged. Aim To evaluate the performance characteristics of a LAMS based on a prospective protocol (CT scan 1 week after placement to assess for resolution and need for necrosectomy followed by stent removal within 3 weeks). Methods This is a descriptive prospective cohort study performed at a single centre. The primary outcome was clinical success. Secondary outcomes were technical success, procedure time, total number of endoscopic procedures with or without necrosectomy, stent indwell time, stent functionality and adverse events. Results Thirty-seven patients (21 males, mean age 46.5 years) underwent placement of LAMS for 41 PFCs (median size 12 cm). There were 18 pseudocysts and 23 walled-off necrosis. Clinical success was seen in 33 of 41 (80%) PFCs. Of the remaining eight patients, six underwent surgery and two patients died from underlying malignant disease (although their PFC had completely resolved). Technical success and stent functionality were 100%. The median procedure time was 14 min (interquartile range 11 min to 20 min). Of the 23 walled-off necrosis, 9 (39%) required necrosectomy. The median stent indwell time was 19 days (interquartile range 14 to 22 days). There were no serious adverse events. Conclusions Our protocol demonstrates excellent performance characteristics of LAMS. Their clinical efficacy and favourable safety profile suggest that they may be the preferred modality for endoscopic ultrasound-guided management of PFCs.

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