Endoscopic ultrasound-guided drainage of pancreatic collections with dedicated metal stents: A nationwide, multicenter, propensity score-matched comparison

• Published in: Digestive and liver disease Vol. 56; no. 1; pp. 159 - 169
• Main Authors: Coluccio, Chiara, Facciorusso, Antonio, Forti, Edoardo, De Nucci, Germana, Mitri, Roberto Di, Togliani, Thomas, Cugia, Luigi, Ofosu, Andrew, Anderloni, Andrea, Tarantino, Ilaria, Fabbri, Carlo, Crinò, Stefano Francesco, Binda, Cecilia, Petrone, Maria Chiara, Berretti, Debora, Macchiarelli, Raffaele, Lovera, Mauro, Attili, Fabia, D'Errico, Francesca, Brancaccio, Mario Luciano, Redaelli, Alessandro, Tasini, Enrico, Ballarè, Marco, Coppola, Franco, Leone, Nicola, Grassia, Roberto, Fusaroli, Pietro, DeAngelis, Claudio, Cipolletta, Fabio, Manno, Mauro, Badas, Roberta, Pollino, Valeria, Camellini, Lorenzo, Bernardoni, Laura, Conte, Elisabetta, Lisotti, Andrea, Mutignani, Massimiliano, Traina, Mario, Arcidiacono, Paolo Giorgio
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.01.2024
• Subjects: Bi-flanged metal stents; Lumen-apposing metal stents; Pancreatic fluid collection; Bi-flanged metal stents; Pancreatic fluid collection; Lumen-apposing metal stents
• ISSN: 1590-8658; 1878-3562; 1878-3562
• DOI: 10.1016/j.dld.2023.07.012

The new dedicated stents for endoscopic ultrasound (EUS)-guided transluminal drainage of peri‑pancreatic fluid collections (PFCs) demonstrated optimal efficacy and safety profiles. This study aimed to evaluate the safety, technical and clinical success, and recurrence rate of PFCs drained with Lumen Apposing Metal Stent (LAMS) or Bi-Flanged Metal Stent (BFMS). Data from a multicenter series of PFCs treated with LAMS or BFMS at 30 Italian centers during a 5-year period were retrieved. The rate of adverse events (AEs), technical success, clinical success, PFC recurrence were evaluated. To overcome biases, a 1-to-1 match was created using propensity score analysis. Out of 476 patients, 386 were treated with LAMS and 90 with BFMS, with a median follow-up of 290 days (95% CI 244 to 361). Using propensity score matching, 84 patients were assigned to each group. The incidence of AEs did not differ between the two stents (13.1% versus 15.5%, p = 0.29), mainly bleeding or recurrence rate (4.7% versus 3.5%, p = 1). Technical and clinical success in the BFMS and LAMS groups were 92% versus 95% (p = 0.36) and 91% versus 94% (p = 0.64), respectively. Our study demonstrates that LAMS and BFMS have comparable safety profiles with similar technical and clinical success rates for EUS-guided PFC drainage.