CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(01): E76-E80
DOI: 10.1055/a-1968-7596
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EUS-guided endoscopic internal drainage with lumen-apposing metal stent for symptomatic hepatic cysts: a case series (with video)

Francesca DʼErrico
1   Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
2   Unit of Gastroenterology and Digestive Endoscopy, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti
,
Serge Derhy
1   Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
,
Maurizio Fazi
1   Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
,
Riccardo Memeo
3   Unit of Hepato-Pancreatic-Biliary Surgery, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti
,
Francesco Decembrino
2   Unit of Gastroenterology and Digestive Endoscopy, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti
,
Giovanni D. De Palma
4   Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
,
Gianfranco Donatelli
1   Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
4   Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
› Author Affiliations

Abstract

Background and study aims Simple hepatic cysts (SHCs) are usually asymptomatic and detected incidentally. However, larger cysts may present with clinical signs and require treatment such as percutaneous aspiration or surgery with non negligeable rate of recurrence. We report a series of 13 consecutive patients who underwent EUS-guided lumen-apposing metal stent (LAMS) drainage of SHCs of the right and left liver.

Patients and methods Nine men and four women, average age 71.9 years, underwent EUS-guided LAMS cyst drainage because of significant symptoms. At 1 month, LAMS was exchanged for a double pigtail stent (DPS), which was left in place for 3 months. Nine of the SHCs were located in the right liver and four in the left. The average diameter was 22.2 cm.

Results Thirteen LAMS were successful delivered in all patients. However only 12 of 13 (92.3 %) remained in place. In one case, the LAMS slipped out immediately and was promptly removed and the cyst treated percutaneously. One of 12 patients experienced bleeding, which was treated conservatively. In seven patients, the LAMS was exchanged for a DPS; in the other five, it was successfully left in place until the patients died, given their comorbidities. At 10.5 months of follow-up, none of the SHCs had recurred.

Conclusions EUS-guided LAMS drainage permits treatment of symptomatic SHCs without recurrence and with few adverse events. Comparative studies are needed to consider this approach as first intention.



Publication History

Received: 27 June 2022

Accepted after revision: 25 October 2022

Accepted Manuscript online:
27 October 2022

Article published online:
19 January 2023

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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