EUS-guided pseudocyst drainage: prospective evaluation of early removal of fully covered self-expandable metal stents with pancreatic ductal stenting in selected patients - 01/06/16
Abstract |
Background |
EUS-guided pseudocyst drainage with fully covered self-expandable metal stents (FCSEMSs) was recently described. The appropriate period for stent removal is not known.
Objective |
To assess the safety and efficacy of EUS-guided FCSEMS placement for 3 weeks, along with pancreatic ductal stenting in selected patients.
Study Design |
Prospective, single-center evaluation.
Setting |
Tertiary referral center.
Patients |
Symptomatic pseudocysts in the body and tail region of the pancreas.
Interventions |
EUS-guided transgastric placement of FCSEMS. MRCP was performed after 3 weeks. Patients with a suspected pancreatic duct leak underwent ERCP and plastic stent placement. The FCSEMSs were removed at 3 weeks.
Main Outcome Measurements |
Success of FCSEMS placement, adverse events, and recurrence rate.
Results |
Forty-seven patients met the eligibility criteria. Technical and functional success was achieved in 43 patients (intention to treat, 91.48% and 95.34% patients [per protocol, 41/43, respectively]). Adverse events occurred in 2 patients (cyst infections, 4.6%). Follow-up of 42 patients at 3 weeks was performed. MRCP detected a ductal leak in 3 patients (7.1%) and a disconnected duct in 2 patients (4.7%). ERCP and stenting were successful in all 3 patients with a ductal leak. During a median follow-up of 306 days in 42 patients, 2 recurrences (4.7%) were detected, both in patients with disconnected duct. Multivariate analysis showed that pancreatic ductal leak or disconnection was an independent factor affecting pseudocyst resolution at 3 weeks (P = .0001).
Limitations |
Single-center study.
Conclusion |
Short-term placement of FCSEMSs with pancreatic ductal stenting in selected patients appears safe and effective for the treatment of pseudocysts.
Il testo completo di questo articolo è disponibile in PDF.Abbreviation : FCSEMSs
Mappa
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
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| See CME section; p. 718. |
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| If you would like to chat with author of this article, you may contact Dr Dhir at vinaydhir@gmail.com. |
Vol 82 - N° 4
P. 650-657 - ottobre 2015 Ritorno al numero
Articolo precedente
- Endoscopy/EUS-guided fiducial marker placement in patients with esophageal cancer: a comparative analysis of 3 types of markers
- Melanie Machiels, Jeanin van Hooft, Peng Jin, Mark I. van Berge Henegouwen, Hanneke M. van Laarhoven, Tanja Alderliesten, Maarten C. Hulshof
- Pancreatic pseudocysts: Is shorter duration of drainage an option?
- Amy Tyberg, Michel Kahaleh
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