Multicenter study of the efficacy and safety of electrocautery-enhanced lumen-apposing metal stents for the internal drainage of pancreatic fluid collections

• Published in: Scientific reports Vol. 14; no. 1; p. 5481
• Main Authors: Chung, Chen-Shuan, Kuo, Yu-Ting, Chiu, Yi-Chun, Lin, Yang-Chao, Yang, Chi-Ying, Chen, Kuan-Chih, Liao, Szu-Chia, Sun, Cheuk-Kay, Lin, Yen-Chih, Wang, Hsiu-Po
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 06.03.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4020/1503/1712/1714; 692/700/565/2775; Cysts; Endoscopic ultrasound; Humanities and Social Sciences; Implants; Lumen-apposing metal stent; multidisciplinary; Pancreas; Pancreatitis; Pseudocyst; Science; Science (multidisciplinary); Surgical drains; Walled-off necrosis; Wound drainage; Lumen-apposing metal stent; Pseudocyst; Walled-off necrosis; Endoscopic ultrasound; Pancreatitis
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-53785-8

Pancreatic fluid collections (PFCs) including pancreatic pseudocyst (PP) and walled-off necrosis (WON) are complications after acute pancreatitis. We aimed to evaluate the efficacy and safety of endoscopic ultrasound (EUS)-guided lumen-apposing metal stent (LAMS) placement to manage PFCs. Between June 2019 and May 2023, patients with symptomatic PFCs who underwent EUS-guided electrocautery-enhanced LAMS drainage were enrolled retrospectively from eight tertiary centers in Taiwan. In total, 33 [14 (42.42%) PP and 19 (57.58%) WON] patients were enrolled. Gallstones (27.27%) and abdominal pain (72.73%) were the most common etiology and indication for drainage. The technical and clinical success rates were 100% and 96.97%, respectively, and the mean procedure time was 30.55 (± 16.17) min. Complications included one (3.03%) case of self-limited bleeding; there were no cases of mortality. Seven (21.21%) patients had recurrence. Patients with disconnected pancreatic duct syndrome (DPDS) had a higher recurrence rate than those without (71.43% vs. 38.46%, p = 0.05). After replacing LAMSs with transmural double-pigtail plastic stents (DPSs) in the DPDS patients, the DPS migration rate was higher in the patients with recurrence (100% vs. 33.33%, p = 0.04). In conclusion, drainage of symptomatic PFCs with EUS-guided electrocautery-enhanced LAMS appears to be efficient and safe. Replacing LAMSs with DPSs in DPDS patients was associated with a lower recurrence rate.