Endoscopy 2015; 47(01): 63-67
DOI: 10.1055/s-0034-1378113
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

A novel lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections: a prospective cohort study

Daisy Walter
1  Department Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands
Uwe Will
2  Department of Gastroenterology, Municipal Hospital, Gera, Germany
Andres Sanchez-Yague
3  Endoscopy Unit, Hospital Costa del Sol, Marbella, Spain
Dirk Brenke
4  Department of Internal Medicine II, Department of Gastroenterology, Städt. Klinikum Karlsruhe, Karlsruhe, Germany
Jochen Hampe
5  Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany
Helge Wollny
6  Department of Internal Medicine and Gastroenterology, Medical Center Städte Region Aachen, Würselen, Germany
Jose Miguel Esteban López-Jamar
7  Department of Endoscopy, Hospital Clinico San Carlos, Madrid, Spain
Gertrud Jechart
8  Department of Gastroenterology, Klinikum Augsburg, Augsburg, Germany
Peter Vilmann
9  Department of Surgery, Copenhagen University Hospital Herlev, Copenhagen, Denmark
Joan B. Gornals
10  Department of Endoscopy, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain
Sebastian Ullrich
11  Department of Internal Medicine I, Asklepios Klinik Altona, Hamburg, Germany
Martin Fähndrich
12  Department of Interventional Endoscopy, Klinikum Dortmund, University Münster, Dortmund, Germany
Alberto Herreros de Tejada
13  Department of Gastroenterology, IDIPHIM, Puerta de Hierro University Hospital, Autónoma University, Madrid, Spain
Félix Junquera
14  Department of Digestive Disease, Hospital Parc Tauli, Barcelona, Spain
Ferran Gonzalez-Huix
15  Endoscopy Unit, Clinica Girona, Girona, Spain
Peter D. Siersema
1  Department Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands
Frank P. Vleggaar
1  Department Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands
› Author Affiliations
Further Information

Publication History

submitted 27 January 2014

accepted after revision 25 July 2014

Publication Date:
30 September 2014 (online)

Background and study aims: A novel large-diameter, lumen-apposing, self-expanding metal stent with bilateral flanges was recently developed for endoscopic ultrasound (EUS)-guided transmural drainage of symptomatic pancreatic fluid collections (PFCs). The aim of this study was to evaluate the efficacy and safety of this stent in a large cohort.

Patients and methods: Patients with a PFC undergoing EUS-guided drainage with this novel stent were prospectively enrolled in this multicenter cohort study.

Results: There were 61 patients: 46 patients (75 %) with walled-off necrosis (WON) and 15 (25 %) with a pancreatic pseudocyst. Stent placement was technically successful in 60 patients (98 %, 95 %CI 95 % – 100 %). Clinical success, defined as resolution of clinical symptoms in combination with a decrease in the PFC size to ≤ 2 cm on imaging, was achieved in 93 % of patients with a pancreatic pseudocyst (95 %CI 77 % – 100 %) and in 81 % of patients with WON (95 %CI 69 % – 94 %). Treatment failure occurred in nine patients (16 %, 95 %CI 6 % – 26 %), including four patients who required surgical intervention. Stent removal was performed in 82 % of patients after a median of 32 days (range 2 – 178) and was rated as easy in all but one patient. In 10 patients, endoscopic stent removal was not performed because of stent migration (n = 3), stent dislodgement during necrosectomy (n = 3), stent removal during surgery (n = 2), or refusal by the patient (n = 2). In total, five major complications were reported (9 %, 95 %CI 2 % – 16 %), including PFC infection (n = 4) and perforation (n = 1).

Conclusion: EUS-guided drainage using this novel stent is feasible and the clinical results obtained are promising with a low major complication rate.