International, multicenter retrospective trial comparing the efficacy and safety of bi-flanged versus lumen-apposing metal stents for endoscopic drainage of walled-off pancreatic necrosis

摘要: Background To compare fully covered bi-flanged metal stents (BFMS) and lumen-apposing (LAMS) for endoscopic ultrasound (EUS)-guided drainage/debridement of pancreatic walled-off necrosis (WON). Methods Patients with WON managed by EUS-guided therapy were divided into those who underwent: 1) drainage using BFMS; 2) LAMS scheduled direct necrosectomy (DEN). Clinical success (resolution the WON), technical (successful stent placement), adverse events (AEs) evaluated. Results 387 patients underwent drainage, 205 BFMS 182 LAMS. The clinical in or groups similar (197 [96.1%] vs. 174 [95.6%]; P=0.81). Median number procedures required resolution was significantly lower compared to (2 3, P<0.001). Technical placement (203 [99%] 180 [99%], P=0.90). Procedure-related AEs (19 [9.3%] 20 [10.9%], P=0.61). Stent dysfunction occluding debris higher group (21 [10.2 %] 11 [5.9%], P=0.04). migration rate than (15 [7.3%] 3 [1.6%]; DEN 23 [11.2%] after lack conservative means. Conclusion a "step-up approach" are both safe effective WON.