Endoscopy 2019; 51(04): S179
DOI: 10.1055/s-0039-1681699
ESGE Days 2019 ePoster podium presentations
Saturday, April 6, 2019 13:00 – 13:30: EUS therapeutic miscelaneous ePoster Podium 5
Georg Thieme Verlag KG Stuttgart · New York

MULTICENTER RETROSPECTIVE CASE SERIES ASSESSING ADVERSE EVENTS ASSOCIATED TO THE INDWELL AND STENT RETRIEVAL OF LUMEN APPOSING METAL STENTS

S Bazaga
1   Hospital Universitario Rio Hortega, Valladolid, Spain
,
A Yaiza Carbajo
1   Hospital Universitario Rio Hortega, Valladolid, Spain
,
F Javier García-Alonso
1   Hospital Universitario Rio Hortega, Valladolid, Spain
,
D Martí
2   Hospital Clínico Universitario de Valencia, Valencia, Spain
,
V Sánchiz Soler
2   Hospital Clínico Universitario de Valencia, Valencia, Spain
,
B Martinez Moreno
3   Hospital General Universitario de Alicante, Alicante, Spain
,
J Ramón Aparicio Tormo
3   Hospital General Universitario de Alicante, Alicante, Spain
,
R Pedraza Sanz
4   Hospital General Universitario Castellón, Castellón, Spain
,
R Villanueva Hernández
5   Hospital de Ávila, Ávila, Spain
,
J Vila Costas
6   Complejo Hospitalario de Navarra, Pamplona, Spain
,
E Vázquez Sequeiros
7   Hospital Ramón y Cajal, Madrid, Spain
,
A Jordán Castro
8   Hospital del Bierzo, Ponferrada, Spain
,
M Jiménez Palacios
9   Hospital Universitario de León, León, Spain
,
M Pérez-Miranda
1   Hospital Universitario Rio Hortega, Valladolid, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

The primary aim was to describe all LAMS related adverse events presenting during stent indwell and retrieval. Secondary aims were describing the relationship between indwell time, therapeutic target and adverse events.

Methods:

Multicenter retrospective case series using standardized case report forms including all consecutive patients who received a LAMS (Axios) to reach extraluminal structures from January to December 2017.

Results:

We included 179 patients from 7 centers (range 4 – 68 cases/center), 122 (68.2%) men, mean age 64.3 years (SD: 15.8).

Pancreatic fluid collections (walled-off necrosis 32.4% and pseudocysts 17.3%) were the most frequent indications as shown in table 1, which also includes the proportion of stents retrieved, indwell time and adverse events during stent retrieval.

During stent indwell adverse event appeared in 19 (10.9%) patients, 8 stent obstructions, 7 (3.9%) gastrointestinal bleeds, including one death in hepatic artery pseudoaneurism presenting 9 months after placing a gallbladder drainage, 2 perforations and 2 symptomatic migrations. There were another 6 asymptomatic migrations.

LAMS were not removed in 86 patients (48%), mostly in permanent intended stents, 46 (53.5%), and patients lost to follow-up,18 (20.9%). Stents were retrieved in 93 patients. We observed 5 (5.4%) adverse events during stent retrieval, 3 hemorrhages managed endoscopically and 2 perforations, one managed endoscopically with OTSC clip, and one requiring surgical treatment.

We did not observe an association between indwell time and the presence of adverse events (p = 0.67).

Tab. 1:

Indications

Indication

N° of procedures n (%)

Removed stents n (%)

Delay until stent retrieval (weeks) med (IQR)

Complications during retrieval n (%)

Pancreatic fluid collections

89 (49.7%)

70 (78.7%)

8.7 (4.9 – 13.3)

3 (4.3%)

Gallbrader-drainage

26 (14.5%)

4 (15.4%)

3.5 (2.7 – 8.7)

1 (25%)

Gastrojejunostomy

16 (8.9%)

2 (12.5%)

0

1 (50%)

Choledocoduodenostomy and Hepaticogastrostomy

26 (14,5%)

4 (15.4%)

1.4 (1.1 – 36)

0

Conclusions:

Our study presents a low risk of LAMS related adverse events, despite extended indwell time compared to current recommendations in pancreatic fluid collections.