Comparison of Clinical Outcomes between Plastic Stent and Novel Lumen-apposing Metal Stent for Endoscopic Ultrasound-Guided Drainage of Peripancreatic Fluid Collections

Abstract

Background/Aims Endoscopic ultrasound (EUS)-guided transmural drainage for peripancreatic fluid collections (PFCs) has gained wide acceptance as a nonsurgical intervention. Although a lumen-apposing metal stent (LAMS) was recently introduced, there are few data comparing the clinical outcomes between LAMS and plastic stent (PS) drainage. Methods Endoscopy databases of all patients who had undergone EUS-guided drainage for PFCs were searched and the clinical outcomes of EUS-guided drainage according to stent-type used were compared. Results A total of 27 patients (median age, 56 years) with PFCs underwent EUS-guided transmural drainage between January 2011 and December 2017. Of these, 17 underwent PS placement and 10 underwent LAMS placement. There was no significant difference in the technical success rate between the 2 groups (94.1% vs. 100%, p =1.0). Procedure time was shorter in the LAMS group compared to that in the PS group (10.6±2.5 min vs. 21.4±9.5 min, p =0.002). Among subjects with clinical success, recurrence of PFC after stent removal occurred in 5 of 12 patients with PS and 4 of 10 with LAMS, without statistical difference (41.7% vs. 40.0%, p =1.0). Conclusions Although our study showed similar clinical outcomes for LAMS and PS, further prospective trials are required to validate the superiority of LAMS.

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

“…Our literature searches led to the identification of 1400 articles. After screening the titles and abstracts, 20 studies were found to meet our eligibility criteria ( Figure 1) [3,9,10,[12][13][14][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. A total of 1534 patients were included.…”

Current status of treatments of pancreatic and peripancreatic collections of acute pancreatitis

“…Additionally, the matched cautery-enhanced delivery systems decrease technical difficulty and shorten the procedural time. Even though some studies show LAMS might have a slight advantage over plastic stents in terms of clinical success[ 27 , 59 , 60 ], more studies have shown that there were no differences between LAMS and plastic stents regarding the technical success rate, clinical success, recurrence in drainage of pancreatic, and peripancreatic collections[ 24 , 25 , 60 - 62 ]. In contrast, the bleeding risk (including pseudoaneurysm bleeding, which is life-threatening and may require immediate interventional radiology-guided coil embolization or open surgery) is higher in the LAMS group[ 32 , 61 , 62 ].…”

Current treatment of pancreatic pseudocysts: a systematic review

“…В некоторых многопрофильных ЛПУ совмещают использование обычной методики ТМД с УЗИ, которое называется дренированием при помощи ЭУС, с целью определения местоположения кисты и расстояния от нее до стенки кишечника [59]. Большинство исследователей пришли к выводу, что дренирование при помощи ЭУС имеет лучшие результаты в сравнении с традиционной методикой ТМД, обеспечивая более точную визуализацию псевдокисты и окружающей анатомии, что помогает оператору выбрать оптимальные места для проколов и избежать повреждения крупных сосудов [60,61]. Эти данные делают интра-и послеоперационные осложнения при дренировании с помощью ЭУС менее серьезными по сравнению с осложнениями после традиционного ТМД.…”