Endoscopy 2019; 51(04): S186
DOI: 10.1055/s-0039-1681720
ESGE Days 2019 ePoster podium presentations
Saturday, April 6, 2019 13:30 – 14:00: EUS therapeutic pancreas ePoster Podium 5
Georg Thieme Verlag KG Stuttgart · New York

EUS-GUIDED DRAINAGE OF PERIPANCREATIC FLUID COLLECTIONS BY LUMEN-APPOSING METAL STENTS VERSUS SELF-EXPANDING METAL STENTS VERSUS PLASTIC STENTS: SINGLE CENTER EXPERIENCE OVER 6 YEARS

M Drepper
1   Hepatogastroenterology, Cliniques Universitaires Saint-Luc; Université Catholique de Louvain, Bruxelles, Belgium
2   Gastroenterology, Hôpital de La Tour, Meyrin, Switzerland
,
E Pérez-Cuadrado-Robles
1   Hepatogastroenterology, Cliniques Universitaires Saint-Luc; Université Catholique de Louvain, Bruxelles, Belgium
,
PH Deprez
1   Hepatogastroenterology, Cliniques Universitaires Saint-Luc; Université Catholique de Louvain, Bruxelles, Belgium
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Comparing outcome after peripancreatic fluid collection (PFC) drainage by plastic double pigtail stents versus self-expanding metal stents (SEMS) versus the recently developed lumen-apposing metal stents (LAMS).

Methods:

We retrospectively analyzed our local endoscopic database from January 2012 up to November 2017 in patients who underwent EUS-guided drainage for symptomatic PFC. Exclusion criteria were post-surgical peripancreatic collections and follow-up of less than 30 days. Technical and clinical success, adverse events and mortality as well as re-intervention and recurrence rates were assessed.

Results:

73 patients (mean age: 48 ± 17, 73% males) underwent endoscopic drainage of 75 pancreatic fluid collections (57 pancreatic pseudocysts/PP and 18 walled-off necrosis/WON) by plastic stents (n = 47, 62.7%), SEMS (n = 5, 6.7%) or LAMS (n = 23, 30.7%) using a transgastric (94.7%) or transduodenal (5.3%) approach.

Overall technical and clinical success was 94.7% and 84% respectively. Technical success was higher in plastic stents (100%) and SEMS (100%) compared to LAMS (82.6%) (p = 0.008). However, there was no significant difference in terms of clinical success between the three groups (87.2% vs. 82.6% vs. 60%, p = 0.281).

Intraoperative complication rate was 9.3% (4 bleedings, 3 stent dislodgements) and significantly differed between plastic (n = 1, 2.1%), SEMS (n = 2, 40%) and LAMS (n = 4, 17.4%) (p = 0.006). There was no difference in 30-days complication rate. PFCs treated with SEMS had a higher re-intervention rate (80%) compared to plastic (14.9%) and LAMS (4.3%) (p < 0.001). Similarly, recurrence rate after stent removal was higher in SEMS (60%) compared to plastic stents (14%) and LAMS (13%) (p < 0.028) during the median follow-up of 16.6 months.

Conclusions:

Our results suggest equal clinical efficacy of plastic stents and LAMS in PFC drainage. Despite the small number of patients, SEMS seem nevertheless to be inferior to plastic stents and LAMS. Major advantage of LAMS appears to be a significantly lower re-intervention rate, thereby potentially reducing patient's procedure-induced burden.