Endoscopy 2022; 54(S 01): S230-S231
DOI: 10.1055/s-0042-1745220
Abstracts | ESGE Days 2022
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EQUIVALENT EFFICACY AND SAFETY OF PLASTIC STENTS AND LAMS IN THE TREATMENT OF PERIPANCREATIC FLUID COLLECTION; A PROSPECTIVE STUDY

K. Khodakaram
1   Sahlgrenska University Hospital, Department of Surgery, Gothenburg, Sweden
,
P. Hedenström
2   Sahlgrenska University Hospital, Division of Medical Gastroenterology, Department of Internal Medicine, Gothenburg, Sweden
,
S.-O. Bratlie
1   Sahlgrenska University Hospital, Department of Surgery, Gothenburg, Sweden
,
R. Sadik
2   Sahlgrenska University Hospital, Division of Medical Gastroenterology, Department of Internal Medicine, Gothenburg, Sweden
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Aims Endoscopic ultrasound (EUS)-guided transmural drainage using plastic stents (PS) has been routine for the treatment of peripancreatic fluid collection (PFC). Since 2016 lumen-apposing metal stents (LAMS) have been introduced aiming for better draining efficacy. The aim of this long-term prospective study was to compare the efficacy and safety of PS vs LAMS.

Methods Consecutive patients undergoing EUS-guided drainage between January 2010 and December 2020 were included in a tertiary centre. PS and LAMS were compared regarding technical- and clinical success-rate, adverse event-rate (AE) and the need for re-interventions. Fischer’s test, Kaplan-Meier curves and log-rank tests were performed to investigate the clinical efficacy of the two groups.

Results

Table 1

Clinical Outcome

Plastic Stent (n=53)

LAMS (n=36)

p-value

Technical Success

53 (100%)

36 (100%)

1.0

Clinical success – PFC resolution on CT (n)

31

20

0.94

Overall adverse Events

7

2

0.24

Hospital Stay days (median/IQR)

13/10

12/20

0.65

A total of 89 patients (median age, 56 years) with PFCs underwent EUS-guided transmural drainage (PS: n=53; LAMS: n=36) due to pseudocyst (n=52) or WON (Walled-of necrosis, n=37). Both PS and LAMS had high technical success (100%) and comparable AE and clinical success-rate. Need for re-endoscopy due to treatment failure was 14/53 (26.4%) in PS and 14/36 (38.8%) in LAMS, (p=0.158). No significant difference was found in subgroup analysis of WON and pseudocyst. The 20mm LAMS resulted in less need for rehospitalization (13% vs 43%, p=0.05) compared with 15mm LAMS.

Zoom Image
Fig. 1

Conclusions This large, prospective study on EUS-guided drainage of peripancreatic fluid collections showed equivalent safety, technical success, and clinical success comparing plastic stents and LAMS. The larger diameter of LAMS (20mm) however, seems to have a significant better clinical outcome compared with the standard diameter LAMS (15 mm).



Publication History

Article published online:
14 April 2022

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