SELF-EXPANDABLE METAL STENT (SEMS) VERSUS LUMEN-APPOSING METAL STENT (LAMS) FOR EUS-DRAINAGE OF PANCREATIC FLUID COLLECTIONS: RANDOMIZED CLINICAL TRIAL (RCT)

Aims Endoscopic Ultrasound (EUS)-guided drainage is considered the gold standard for the treatment of encapsulated pancreatic collections (EPCs) – pseudocysts and walled-off necrosis (WON) –, presenting the same clinical efficacy as surgical drainage, but fewer complications and less morbidity. Several types of stents have been developed and used for this purpose, however, there is no strong evidence to support which is the best option. The aim of this RCT is to compare the efficacy and safety of the SEMS versus LAMS for EUS-guided drainage of EPCs.

Methods This is a Randomized Clinical Trial phase IIB comparing SEMS versus LAMS regarding efficacy and safety in EUS-guided drainage of EPCs. Technical success, clinical success, radiological success, adverse events, intra-procedure intercurrences, and procedure time were evaluated. A sample size of 42 patients was determined.

Results There was no difference in technical success, clinical success, radiological success, adverse events, or stent migration rate between the two groups. The procedure time was longer in the LAMS group (mean time 43.81 ± 6.55 min vs 24.43±1.99 min, p=0.001). There were more intra-procedure intercurrences in the LAMS (5) than in the SEMS group (0) (p=0.048).

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Conclusions SEMS and LAMS have similar technical success, clinical success, radiological success, and adverse events. However, the SEMS had a shorter procedure time and fewer intra-procedure intercurrences. The choice of which stent is used for EUS-drainage of EPCs must consider the availability and expertise of the service. Both SEMS and LAMS are possible options with similar clinical efficacy and safety profile.

Publication History

Article published online:
14 April 2022