EUS-guided drainage of peripancreatic fluid collections and necrosis by using a novel lumen-apposing stent: a large retrospective, multicenter U.S. experience (with videos)

摘要: Background and Aims EUS-guided drainage of peripancreatic fluid collection (PFC) (pancreatic pseudocyst [PP] or walled-off necrosis [WON]) by using a novel lumen-apposing, fully covered, self-expandable metal stent (LAMS) has been promising, but few these data are from the United States. The aim this study was to evaluate clinical outcomes safety pancreatic pseudocysts WON LAMS. Methods We conducted multicenter, retrospective on 82 patients with symptomatic PFC who underwent LAMS at 4 U.S. tertiary care centers. Outcomes evaluated included successful placement LAMS, number in whom complete resolution PPs achieved, procedures performed per patient achieve resolution, adverse events. Results mean size 11.8 cm. LAMSs were successfully placed 80 (97.5%). Twelve had PP 68 WON. median in-dwelling time 2 months (range 1-3 months). Endoscopic debridement 54 patients. patency maintained 98.7% (77/78). There spontaneous dislodgment LAMSs. Successful endoscopic therapy 12 (100%) compared 60 (88.2%) All stents endoscopically removed all after resolution. 1 recurrence during 3-month follow-up period. Procedure-related events occurred 8 (9.8%), maldeployment (n = 2), self-limited bleeding 6). In 1 patient gastric perforation developed, surgical repair. Conclusion PFCs high technical long-term success rates. Due its ease use, may simplify streamline management PFCs, particularly for WON, help widespread adoption as an alternative surgery.