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 (eFirst)

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.