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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

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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 (EN)
Shah, Janak
Sharaiha, Reem Z.
Basha, Jahangeer
Adler, Douglas G.
Kahaleh, Michel
Eyck, Patrick Ten
Reddy, Nageshwar D.
Mumtaz, Tayebah
Loren, David E.
Siddiqui, Ali
Kalalala, Rakesh
Ramchandani, Mohan K.
Nabi, Zaheer
Nieto, Jose
Talukdar, Rupjyoti
Murphy, Megan
Noor, Arish
Naveed, Mariam
Kowalski, Thomas E.
Gupta, Rajesh
Lakhtakia, Sundeep
Binmoeller, Kenneth
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
2021-03-05
Background To compare fully covered bi-flanged metal stents (BFMS) and lumen-apposing metal stents (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; and 2) drainage using LAMS and scheduled direct endoscopic necrosectomy (DEN). Clinical success (resolution of the WON), technical success (successful stent placement), and adverse events (AEs) were evaluated. Results 387 patients underwent WON endoscopic drainage, 205 using BFMS and 182 using LAMS. The clinical success in the BFMS or LAMS groups were similar (197 [96.1%] vs. 174 [95.6%]; P=0.81). Median number of procedures required for WON resolution was significantly lower in BFMS compared to LAMS (2 vs. 3, P<0.001). Technical success for stent placement was similar in BFMS and LAMS groups (203 [99%] vs. 180 [99%], P=0.90).Procedure-related AEs were similar in the BFMS and LAMS groups (19 [9.3%] vs. 20 [10.9%], P=0.61). Stent dysfunction with occluding debris was higher in the BFMS group compared to LAMS group (21 [10.2 %] vs. 11 [5.9%], P=0.04). The migration rate was higher in the BFMS group than in the LAMS group (15 [7.3%] vs. 3 [1.6%]; P<0.001). DEN was required in 23 [11.2%] patients in the BFMS group after lack of WON resolution by conservative means. Conclusion BFMS with a “step-up approach” and LAMS with scheduled DEN are both safe and effective for EUS-guided drainage/debridement of WON. Keywords Pancreatic walled off necrosis, acute pancreatitis, bi-flanged metal stents, lumenapposing metal stents, endosonography Ann Gastroenterol 2021; 34 (2): 273-281 (EN)
English
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 34, No 2 (2021); 273 (EN)
Copyright (c) 2021 Annals of Gastroenterology (EN)
Hellenic Society of Gastroenterology
Annals of Gastroenterology
Original Articles



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