A novel lumen-apposing metal stent for endoscopic drainage of symptomatic pancreatic fluid collections: a retrospective study

IF 4.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Endoscopic Ultrasound Pub Date : 2023-12-29 DOI:10.1097/eus.0000000000000039
Ning Xu, Longsong Li, Song Su, Danqi Zhao, J. Xiang, Pengju Wang, Yaxuan Cheng, E. Linghu, N. Chai
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Abstract

Previous studies showed that lumen-apposing metal stent (LAMS) provides a feasible route to perform direct endoscopic necrosectomy. However, the high risk of bleeding and migration induced by the placement of LAMS attracted attention. The aim of this study was to evaluate the safety and effectiveness of a novel LAMS. In this retrospective study, we enrolled patients with symptomatic pancreatic fluid collections (PFCs) to perform EUS–guided drainage with a LAMS in our hospital. Evaluation variables included technical success rate, clinical success rate, and adverse events. Thirty-two patients with a mean age of 41.38 ± 10.72 years (53.1% males) were included in our study, and the mean size of PFC was 10.06 ± 3.03 cm. Technical success rate and clinical success rate reached 96.9% and 93.8%, respectively. Stent migration occurred in 1 patient (3.1%), and no stent-induced bleeding occurred. The outcomes of using LAMS in 10 patients with pancreatic pseudocyst and 22 patients with walled-off necrosis were comparable. Compared with pancreatic pseudocyst, walled-off necrosis needed more direct endoscopic necrosectomy times to achieve resolution (P = 0.024). Our study showed that the novel LAMS is effective and safe for endoscopic drainage of PFCs with a relatively low rate of adverse events. Further large-scale multicenter studies are needed to confirm the present findings.
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用于内镜引流无症状胰腺积液的新型管腔封闭金属支架:一项回顾性研究
之前的研究表明,腔隙金属支架(LAMS)为直接进行内镜下坏死组织切除术提供了一条可行的途径。然而,放置 LAMS 所引发的出血和移位的高风险引起了人们的关注。本研究旨在评估新型 LAMS 的安全性和有效性。 在这项回顾性研究中,我们招募了本院有症状的胰腺积液(PFC)患者,在 EUS 引导下使用 LAMS 进行引流。评估变量包括技术成功率、临床成功率和不良事件。 研究共纳入 32 名患者,平均年龄为(41.38 ± 10.72)岁(53.1% 为男性),PFC 的平均大小为(10.06 ± 3.03)厘米。技术成功率和临床成功率分别达到 96.9% 和 93.8%。1例患者(3.1%)发生了支架移位,没有发生支架引起的出血。10 名胰腺假性囊肿患者和 22 名壁脱落坏死患者使用 LAMS 的疗效相当。与胰腺假性囊肿相比,贴壁坏死需要更多的直接内镜坏死切除时间才能解决(P = 0.024)。 我们的研究表明,新型 LAMS 是内镜引流 PFCs 有效且安全的方法,不良反应发生率相对较低。需要进一步的大规模多中心研究来证实本研究结果。
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来源期刊
Endoscopic Ultrasound
Endoscopic Ultrasound GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
6.20
自引率
11.10%
发文量
144
期刊介绍: Endoscopic Ultrasound, a publication of Euro-EUS Scientific Committee, Asia-Pacific EUS Task Force and Latin American Chapter of EUS, is a peer-reviewed online journal with Quarterly print on demand compilation of issues published. The journal’s full text is available online at http://www.eusjournal.com. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal does not charge for submission, processing or publication of manuscripts and even for color reproduction of photographs.
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