Endoscopy 2019; 51(04): S58
DOI: 10.1055/s-0039-1681341
ESGE Days 2019 oral presentations
Friday, April 5, 2019 14:30 – 16:30: EUS therapeutic pancreas South Hall 2B
Georg Thieme Verlag KG Stuttgart · New York

LUMEN-APPOSING METAL STENTS VERSUS DOUBLE PIGTAIL PLASTIC STENTS FOR ENDOSCOPIC DRAINAGE OF PERIPANCREATIC FLUID COLLECTIONS: RESULTS FROM A MULTICENTER EUROPEAN STUDY

AD Sioulas
1   Department of Gastroenterology, Hygeia Hospital, Athens, Greece
,
MC Petrone
2   Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy
,
M Tadic
3   Endoscopy Unit, Dept. of Gastroenterology, Hepatology and Clinical Nutrition, Dubrava University Hospital, Zagreb, Croatia
,
I Karoumpalis
4   Division of Gastroenterology, General Hospital of Athens 'G. Gennimatas', Athens, Greece
,
I Hritz
5   Center for Therapeutic Endoscopy Semmelweis University, 1st Department of Surgery, Budapest, Hungary
,
D Kypraios
6   Department of Gastroenterology, Saint Savvas Oncological Hospital, Athens, Greece
,
I Scotiniotis
1   Department of Gastroenterology, Hygeia Hospital, Athens, Greece
,
A Vezakis
7   2nd Department of Surgery, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
,
P Kanavidis
8   1st Department of Surgery, National and Kapodistrian University of Athens, Laikon Hospital, Athens, Greece
,
B Keczer
5   Center for Therapeutic Endoscopy Semmelweis University, 1st Department of Surgery, Budapest, Hungary
,
G Tziatzios
9   Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
,
P Gkolfakis
9   Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
,
K Triantafyllou
9   Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
,
A Polydorou
7   2nd Department of Surgery, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
,
I Grgurevic
3   Endoscopy Unit, Dept. of Gastroenterology, Hepatology and Clinical Nutrition, Dubrava University Hospital, Zagreb, Croatia
,
PG Arcidiacono
2   Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy
,
IS Papanikolaou
7   2nd Department of Surgery, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
9   Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 
 

    Aims:

    Endoscopic ultrasound (EUS)-guided drainage is used to treat symptomatic peripancreatic fluid collections (PFCs). We performed a retrospective cohort study to compare the technical/clinical outcomes and adverse events of drainage with lumen-apposing metal stents (LAMSs) and double pigtail plastic stents (DPSs).

    Methods:

    Data from patients with PFCs managed either with LAMSs (Hot Axios, Boston Scientific, Marlborough, MA, USA) or DPSs in 8 tertiary European centers were collected. Technical success (ability to place), clinical success (ability to drain), early adverse events, ease of placement (1 – 10, 1 = extremely difficult), intervention duration, drainage duration and complications on removal were evaluated.

    Results:

    97 patients (71 male; mean age, 59.1 years) with PFCs (63 pseudocysts, 33 walled-off necroses-WON, 1 gallbladder empyema) underwent drainage using LAMSs (n = 84, group 1) and DPSs (n = 13, group 2). Groups were matched for gender, collection type and location. Collection diameter was smaller in group 1 (mean, 10.6 cm vs. 16.5 cm, p = 0.007) and group 1 patients were older (mean, 60.5 vs. 50.4 years, p = 0.002). DPSs were placed with transgastric approach, while 13.1% of LAMSs transduodenally. No differences were noticed regarding technical success (96.4% vs. 100%, p = 1.00), clinical success (95.1% vs. 92.3%, p = 1.00) or ease of placement (8 vs. 8, p = 0.913), whereas LAMSs placement lasted shorter (mean, 9.2 vs. 46.1 min, p < 0.001). Early complications occurred in 15.6% of group 1 patients (6% bleeding, 4.8% obstruction, 2.4% migration, 2.4% perforation) and in 7.7% of group 2 patients (7.7% perforation), p = 1.00. Drainage duration was shorter in group 1 (mean, 51.5 vs. 101.5 days, p = 0.004). Complications on removal occurred in 10.7% of group 1 patients (7.1% buried stent, 3.6% bleeding), and in none of group 2.

    Conclusions:

    PFCs drainage with LAMSs equals DPSs regarding technical success, clinical success and early adverse events. LAMSs placement is faster and requires a shorter drainage period. LAMS removal may be accompanied with serious complications.


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