Epidemiological studies on Acute Pancreatitis (AP) are significantly scarce in the Saudi Arabian Literature. In this paper, we aim to explore the current trends of AP in a sample of Saudi patients. This is a cross-sectional study in which we reviewed AP-related admissions from 2014 to 2017. Data collected included demographics, clinical presentation, investigations, severity, complications, and the outcome at the end of hospitalization. During the study period, 107 patients were admitted due to AP. Fifty-seven (53%) were males. Biliary pancreatitis was the most common etiology found among our patients (39.3%; 95% CI: 30.5-48.7), followed by alcoholic pancreatitis (11.2%; 95% CI: 6.5-18.6) and hypertriglyceridemia (8%; 95% CI: 4.5-15.2). Pancreatic pseudocysts were the most common complication we found in this series (15%; 95% CI: 9.4-23). Of all the hospitalized patients in this study, eight patients (7.9%) died (95% CI: 3.8-14.1). The number of AP-related admissions and mortality rate appear to have increased as compared with the numbers in earlier national studies. The etiological groups have also changed. As compared with Western/Asian studies, however, there was almost no difference in the epidemiological patterns except for the mortality rate.

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Background and aims  Postoperative leak is one of the most feared complications after bariatric surgery. Endoscopic stenting is used to manage leaks by decreasing the gastrointestinal intraluminal pressure. The main advantage of endoscopic management is providing healing while still allowing for oral nutrition. However, limited literature exists on whether biodegradable stents can be used to control leaks when conventional metallic stents fail. Methods  Our series consists of four patients who were found to have a leak as a complication of bariatric surgery. Two patients were initially managed by abdominal/chest drainage, and one required total parenteral nutrition. Conventional endoscopic exclusion techniques with short and long fully covered metallic stents were tried and failed in three of the four patients included in this series. Thus, biodegradable stents were used as a rescue option. Results  Biodegradable stents provided immediate improvement for all of the patients, and Gastrografin studies were leak-free 2 days after the procedure. All patients were started on oral feeding and discharged home within 5 – 6 days later. Minimum outpatient follow-up of 8 weeks was achieved with no issues. Follow-up endoscopy was performed 2 – 3 months later in three patients and showed completely resorbed stents. The only drawback was the mucosal reaction to the stent causing dysphagia in two patients, who eventually needed esophageal dilatation. Conclusion  Biodegradable stents have the potential to provide a reasonable rescue option to manage post bariatric surgery leaks in patients who fail conventional endoscopic exclusion methods. However, data from larger studies are needed to collect information on which theoretical advantages/disadvantages of degradable biomaterials apply to real practice.

Background: Peripancreatic fluid collections (PFCs) are a frequent complication of acute pancreatitis. Symptomatic PFCs may need to be drained, and there are multiple endoscopic accessories that can facilitate the procedure. This paper aims to compare the success rate, number of procedures required for resolution and adverse events rate for PFCs EUS-guided drainage with plastic stents and lumen-apposing metal stents (LAMS). Methods: This is a retrospective analysis of a consecutive sample of patients that was collected from 2013 – 2019. The medical records of these patients were reviewed, and the outcomes for each type of stent (plastic vs LAMS, and different subtypes of LAMS) were compared in terms of clinical success, number of re-interventions needed, and adverse events. Results: A total of 33 patients (23 males) were treated for PFCs with EUS-guided drainage and stenting. The patients' ages ranged between 14 and 85 years (mean ± SD: 43.5 ± 19 years). Overall, there was no difference between plastic stents and LAMS in terms of symptomatic recovery ( P = 0. 24), but metal stents had better results with regards to radiological resolution ( P = 0.03), and were associated with a higher number of necrosectomies ( P = 0.029). Adverse events occurred more frequently in patients who had plastic stents, but direct comparison between the two groups showed that the difference was not statistically significant ( P = 0.2). Stratification for different LAMS subtypes showed no difference in terms of symptomatic or radiological resolution ( P =0.49), number of rescue procedures ( P = 0.41), and adverse events ( P = 0.81). Conclusion: Our study, along with the current available evidence, suggests a slight advantage of metal stents over plastic stents in terms of clinical success, need for rescue procedures, and incidence of adverse events. Furthermore, it provides empirical evidence that the different sub-types of LAMS perform similarly when compared against each other.