Endoscopy 2019; 51(04): S186-S187
DOI: 10.1055/s-0039-1681722
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

IMMEDIATE DIRECT ENDOSCOPIC NECROSECTOMY FOLLOWING ONE-STEP EXCHANGE FREE EUS-GUIDED DRAINAGE OF WALLED OFF PANCREATIC NECROSIS

D Ligresti
1   Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
,
E Utzeri
2   Department of Medical Science, University of Cagliari, Cagliari, Italy
,
F Cipolletta
3   Endoscopy Service, Ospedale del Mare, Naples, Italy
,
M Amata
1   Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
,
L Barresi
1   Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
,
A Granata
1   Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
,
M Traina
1   Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
,
I Tarantino
1   Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 

Aims:

EUS-guided drainage with Lumen Apposing Metal Stents (LAMS) and direct endoscopic necrosectomy (DEN) is an effective mininvasive treatment of infected or symptomatic WOPNs. It revealed a lower complication and mortality rate compared to surgery or percutaneous approach. The aim of our study is to evaluate efficacy and safety of EUS-guided drainage of infected WOPNs with a LAMS and immediate DEN in a consecutive cohort of patients.

Methods:

All consecutive patients with infected or symptomatic WOPN from February 2014 to June 2018 were retrospectively reviewed. All patients underwent electrocautery-enhanced LAMS (EC-LAMS) placement with the “one-step exchange-free” technique. Immediate DEN with hydrogen peroxide irrigation was performed following stent placement in all patients. DEN was then repeated until resolution of the WOPN. The primary outcomes were to evaluate survival rate and clinical success. Secondary outcomes included: technical success, adverse events (AEs) and number of procedures per patient.

Results:

45 patients were treated in the study period. Clinical success was of 88,8%. Survival rate was 91 and 88,8% at 1 and 3 months, respectively. Technical success was achieved in 97,7% of patients and no procedure-related AEs occurred. Mean number of procedure per patient was 3,7. In the follow-up time (mean of 687 days) pseudocyst formation was observed in two cases, successfully treated by endoscopic therapy.

Conclusions:

Immediate DEN following EUS-guided one-step exchange-free EC-LAMS placement is an effective and safe treatment for infected or symptomatic WOPNs.