Endoscopy 2019; 51(04): S224
DOI: 10.1055/s-0039-1681839
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Endoscopic ultrasound ePosters
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC MANAGEMENT OF PANCREATIC FLUID COLLECTIONS (PFC): A SINGLE CENTRE EXPERIENCE WITH LUMEN APPOSING METAL STENTS (LAMS)

S Rizza
1   Division of Gastroenterology, AOU Città della Salute e della Scienza, Torino, Turin, Italy
,
P Cortegoso Valdivia
1   Division of Gastroenterology, AOU Città della Salute e della Scienza, Torino, Turin, Italy
,
L Venezia
1   Division of Gastroenterology, AOU Città della Salute e della Scienza, Torino, Turin, Italy
,
CG De Angelis
1   Division of Gastroenterology, AOU Città della Salute e della Scienza, Torino, Turin, Italy
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Publikationsverlauf

Publikationsdatum:
18. März 2019 (online)

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Aims:

PFC may require drainage in case of persistent symptoms, infection or rapid increase in size. The endoscopic management is challenging and the appearance of LAMS could overcome some limitations of surgical and percutaneous drainage, such as leakage and migration.

Methods:

All patients who underwent LAMS placement for PFC drainage in our centre from November 2016 to November 2018 were included. We collected data regarding type of PFC and drainage, technical success, resolution/reduction of collection and complications. In all cases we had a CT describing the PFC prior to stent placement. Stents used measured 10 mm in length, with two different lumen diameters (10 mm and 15 mm). Transabdominal US was executed the day after and a CT after 3 – 4 weeks. LAMS were retrieved within 4 weeks.

Results:

Fifteen patients (10 M and 5 F, median age 58.6) with PFC were treated with LAMS. Indications were: pseudocist in 13 cases, walled-off pancreatic necrosis (WOPN) in 2 cases. The median size was 10.1 cm. The drainage was transgastric in 13 patients, transduodenal in 2. PFC were solved in 9 cases (60%) and reduced significantly in 6 (40%). Two patients needed endoscopic necrosectomies and/or hydrogen peroxide irrigation after stent placement. In a case of reduced PFC further endoscopic attempts were made with a double-pig tail plastic stent, first, and subsequently with a second LAMS. Stent-related adverse events were observed in 2 patients: we experienced “stent buried syndrome” under the gastric mucosa, both cases solved endoscopically but in one case the distal flange remained imprisoned in the retroperitoneum and it is still in place, not causing any symptoms. There was no procedure-related or 30 day mortality.

Conclusions:

This monocentric study demonstrates that LAMS can be considered a safe and effective approach with a high technical success rate and a very low serious adverse events rate.