Temporary Access Fistulas (TAFs) Using Covered Self-Expandable Metal Stents (cSEMS): A Feasible Tool for Interventional Pancreaticobiliary Endoscopy

Unique Usage of a Partially Covered Metal Stent for Drainage of a Pancreatic Pseudocyst via Endosonography‐guided Transcystgastrostomy

“…To our knowledge, this is the first single case report of EUS‐guided trans‐cystgastrostomy of a pancreatic pseudocyst via utilization of a single‐step PCSEMS. An abstract published in 2007 briefly wrote about the use of PCSEMS, but the stents in that study were tracheal and enteral‐based stents that were used for draining pancreatic fluid collections 10 . Our reasoning for selecting a PCSEMS over a FCSEMS is that the PCSEMS will allow a modest amount of epithelialization to occur which will help secure the PCSEMS to the pseudocyst walls and prevent migration from occurring.…”

Advancements in the endoscopic treatment of pancreatic fluid collections

“…However, as plastic stents have limited diameter and can not provide access for endoscopic necrosectomy to treat WON, metal stents have gradually replaced plastic stents for clinical use. Manuel et al 10 reported the first use of a self-expanding biliary metal stent to drain PPC through the intestinal wall in 2007. Large-diameter stents allow an endoscope to be inserted into the cyst to remove necrotic tissue for drainage.…”

Endoscopic retrograde cholangiopancreatography

“…These largely favorable findings seem to lead to the conclusion that temporary stenting with covered SEMS is a viable alternative to surgery in highly selected patients. In one clever application of this technology, investigators de− scribed their use of large−diameter covered SEMS as a conduit for iterative endoscopic interventions [10]. Covered SEMS were placed through mature tracts created initially by EUS−guided transmural access to dilated intrahepatic ducts and pancreatic fluid collections.…”